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LIBRARY OF CONGRESS. 

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UNITED STATES OF AMERICA. 






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HANDBOOK 



Popular Medicine 



embracing 

the anatomy and physiology op the human body; illustra- 
tions of home gymnastics; instructions foe nursing the 
sick'; the domestic treatment of the ordinary 
diseases and accidents of children and 
V-'adults; plan for a family 
health record, etc. 



OVEE 300 CHOICE DIETETIC AND REMEDIAL RECIPES, 
AND MORE THAN 100 ENGRAVINGS ON WOOD. 



ESPEC TALLY ADAPTED 

FOR GENERAL AND FAMILY INSTRUCTION AND REFERENT 



By GEORGE II. NAPHEYS, A.M., M.D., Etc, 



Hn)t0£if to tlje Cutest JDate. 



PHILADELPHIA: 

HZ. O- WATTS OO. 
1878. 




Yv£ 






Entered according to Act of Congress, in the year 1873. 

By D. G. BRIXTON, 

in the Office of the Librarian of Congress, at Washington. 
All rights reserved. 



BIOGRAPHICAL SKETCH 



GEORGE HENRI NAPHEYS, M.D. 



Were man's life measured by his deeds, as the poet sug- 
gests, how brief would be the long years of many an octo- 
genarian, and how extended the short span which has been 
allotted to not a few of the world's famous heroes ! 

This oft-repeated thought strikes us forcibly in consider- 
ing the biography of the subject of this sketch. Closing 
his life at an age when most professional men are but begin- 
ning theirs, he had already studied broadly, had traveled 
widely over two continents, had gained credit and fame by 
the sword and the pen, and had amassed a fund of erudition 
and experience which the more lethargic lives of most men 
fail to approach after twice his length of days. It is emi- 
nently appropriate that a record of his busy career should 
be attached to the works on which his celebrity is chiefly 
based, and in which he most conspicuously displays that 



ii BIOGRAPHICAL SKETCH. 

command of language and happy facility of imparting in- 
struction for which he was so remarkable. 

George Henry Xaphets (pronounced Na'feez, the a as 
in fate) was born in the city of Philadelphia, March 5th, 
1842. His parents died while lie was still at a tender age, and 
he was placed with some relatives who resided in the city. 
From early years he was characterized by quick perceptions 
and a retentive memory. In the Philadelphia High School, 
from which he received the academic degree of Master of 
Arts, he was considered the best scholar in his class, a 
marked distinction in view of the large numbers which 
attend that institution. Besides acquiring the usual studies 
of the High School, he gave considerable time to phono- 
graphy, in which he became so skilled that he could report 
any ordinary speaker with entire accuracy. This subse- 
quently proved a great advantage to him in his medical 
career. 

After his graduation he repaired to Hartford, Conn., 
where he was offered and accepted the position of private 
secretary to a gentleman of prominence in the literary and 
religious world. 

Thus he was engaged when the civil war broke out. 
With his natural warmth of feeling and strong emotions, he 
entered the fray among the first, and went out as Lieuten- 
ant, and subsequently as Captain, Company F, 10th Con- 
necticut State Volunteers. The regiment was enlisted f r 
nine months, and was dispatched to Louisiana, G 



BIOGRAPHICAL SKETCH. Ill 

Banks then commanding the Department. It participated 
in engagements near Baton Rouge and on the Red River, 
in which Captain Naphcys always acquitted himself with 
bravery and credit. 

At the time the regiment was disbanded, an early prefer- 
ence for medical subjects led him to devote a year to the 
preliminary studies of that profession, but not waiting the 
full period required for a degree, he was appointed assistant 
medical officer on the tl S. steamer Mingo, of the South 
Atlantic Blockading Squadron. On her he passed a number 
of months, cruising off the coast of the Carolinas and 
Georgia, and ascended the St. John river. 

These active duties prevented him from receiving his 
degree of Doctor of Medicine until after the close of the 
war, when, in 1866, his diploma was conferred upon him 
by the Jefferson Medical College of Philadelphia, one of the 
most renowned institutions of our country. 

After graduation, he opened an office in Philadelphia, 
and connected himself with the clinics which are held at 
the College for the purpose of supplying medicine and 
medical advice to the poor gratuitously, as well as for giving 
students an opportunity of witnessing various forms of dis- 
ease. The practical experience he gained in this manner 
was considerable, and his natural ability socn recommended 
him to the authorities of the institution, who appointed him 
Chief of Medical Clinic of the College, a position he held 
for several years. 



IV BIOGRAPHICAL SKETCH. 

One of the advantages of this post was that it brought 
him into constant communion with many eminent medical 
men, and rendered him practically acquainted with their 
treatment of disease. His skill in phonography enabled 
him to take abundant notes of their lectures, and this led to 
his early connection with the periodical literature of the 
profession. Most of the reports he drew up were published 
in the Medical and Surgical Reporter, a weekly journal, 
devoted to medical science, published in Philadelphia. The 
scries of reports commenced in April, 18G6, and continued, 
with slight interruptions, until June, 1870. They are 
characterized by a clear and correct style, and a manifestly 
tin in muli grasp of the numerous topics treated. 

The success which these ephemeral writings obtained 
turned his thoughts in the direction of authorship. His 
tastes and associations led him to employ his powers in two 
directions : first, in preparing for the general public a series 
of works which would acquaint them with anatomy, physi- 
ology, hygiene, sanitary science, nursing, and the manage- 
ment of disease, to the extent that intelligent general readers 
can and ought to know about these subjects ; and secondly, 
in writing for professional men several treatises on the 
means of alleviating and curing diseases. 

In the prosecution of the first mentioned of these plans, 
he was early impressed with the utter absence of any trea- 
tise cm the hygiene of the sexual life in cither sex, written 
in the proper spirit by a scientific man. The field'had been 



BIOGRAPHICAL SKETCH. V 

left to quacks or worse, who, to serve their own base ends, 
scattered inflammatory and often indecent pamphlets over 
the land ; or else, had one or more of the points been handled 
by reputable writers, it was in such a vague and imperfect 
manner that the reader gained little benefit from the perusal. 
While all agreed that a sound treatise on these topics was 
most desirable, it had been openly averred that it could not 
be written in a proper style for the general public. 

Strong in the conviction that pure motives, literary tact, 
and the requisite scientific knowledge qualified him to un- 
dertake this difficult task, Dr. Napheys prepared, in the 
early months of 1869, his work on " The Physical Life of 
Woman." Proceeding with caution, he first submitted the 
MSS. to some professional friends, and profited by their 
suggestions. After the work was in type, and before pub- 
lication, he sent complete copies to a number of gentlemen, 
eminent as medical teachers, clergymen, educators, and liter- 
ateurs. Their replies left him in no doubt but that he had 
succeeded even beyond his anticipations. Almost unani- 
mously the opinions were complimentary in the highest 
degree, and evidently written after a close examination of 
the book. As many of these have been printed to accom- 
pany the work, in the last and previous editions, it is need- 
less to do more in this connection than to say that they were 
penned by such judges as Dr. W. A. Hammond, late Sur- 
geon-G-eneral U. S. Army ; Dr. Harvey L. Byrd, Professor 
in the Medical Department of Washington University, Md. ; 



VI BIOGRAPHICAL SKETCH. 

Dr. Edwin M. Snow, Health Officer of the City of Provi- 
dence, It. I. ; Rev. Henry Ward Beecher, Rev. Horace 
Bushnell, D.D., Rev. George A. Crooke, D.D., D.C.L., and 

others. 

On its appearance, the work was received with enthusi- 
asm by both the medical press and the public. While a 
few journals and individuals were inclined to condemn it 
and censure the author, the intelligent and the pure-minded, 
on all sides, recognized in him the only writer who had yet 
appeared able to treat these delicate subjects with the dig- 
nity of science and the straightforwardness necessary for 
popular instruction. 

Satisfied that he had chosen the proper exercise for his 
talents, he composed and placed in the hands of his pub- 
lisher, the following year, his not less extraordinary work, 
" The Transmission of Life," a treatise addressed to the 
male, as his previous one had been to the. female sex. It 
was dedicated to the late Rev. John Todd, so well known 
for his interest in young men, and his " Student's Manual " 
and other works addressed to them. He accepted the dedi- 
cation and addressed the author a letter, in which occurs the 
following high compliment to his work : "lam surprised 
at the extent and accuracy of your reading ; the judicious- 
ness of your positions and results ; the clear, unecpiivocal, 
yet delicate and appropriate language used ; and the amount 
of valuable information conveyed." Similar expressions 
poured in from many other distinguished critics, as, for in- 



BIOGRAPHICAL SKETCH. VU 

stance, Dr, Noali Porter, President of Yale College ; the 
Iiev. Henry Clay Trumbull, the Key. Abner Jackson, Pre- 
sident of Trinity College, Hartford, etc. 

In the same year (1870) he brought out the first edition 
of his " Modern Therapeutics," a technical work, addressed 
to physicians. This was enlarged in successive editions, 
until in its present form, as continued by other hands in its 
latest editions, it comprises two parts of 600 pages each. 
Although the author claimed little other originality in this 
work than the selection and arrangement of known facts, 
yet in these respects he displayed the strongly practical and 
original turn of his mind. As a student of the art of Thera- 
peutics in large hospitals, clinics, and dispensaries, he had 
convinced himself that it is not by experiments on lower 
animals, nor yet on the human body in health, that the 
physician can attain the glorious power of alleviating pain 
and curing disease ; it is only through the daily combat 
with sickness, by the bedside and in the consulting room. 
Chemistry and physiology, he believed, could teach but 
little in this branch ; observation and experience everything. 
Hence, in his work on Therapeutics he announced himself 
as " aiming at a systematic analysis of all current and ap- 
proved means of combating disease," selecting his formulse 
and therapeutical directions from the most eminent living 
physicians of all nations. 

This work was most favorably received by medical men ; 
and, edited and revised by competent hands, continues to be 



Vlll BIOGRAPHICAL SKETCH. 

regarded as one of the most valuable works in American 
medical literature. The unanimous opinion of the leading 
medical journals, as well as of its numerous purchasers, have 
testified to its real and great worth to the practitioner of 
medicine. 

Having thus established a wide, popular and professional 
reputation, one which would have guaranteed him a lucra- 
tive practice, it would have tempted another, no doubt, to 
make the most of this opportunity, so rarely granted a young 
physician. Not so was it with Dr. Napheys. No sooner 
had the three works mentioned been completed than he 
sailed for Europe, in order to familiarize himself with the 
famed schools of learning of the Old World and its rich 
stores of material for culture. The summer was that of the 
Franco-German war ; and spending most of it in Paris, he 
was witness of several of the most exciting scenes which 
attended the dethronement of the Emperor. These he 
would describe afterwards with a vividness and power of 
language rarely excelled; 

The excitement of the period did not, however, withdraw 
his attention from the studies he had in view. These were 
partially indicated in a series of letters he contributed to 
various periodicals during his absence. While thfise letters 
were principally of a scientific character, it is notewortby 
how the relations of medicine to the welfare of man always 
occupied his attention. Thus we find, in one sent from 
England, June, 1S70, a description of the Liverpool Mcdi- 



BIOGRAPHICAL SKETCH. IX 

cal Missionary Society, a charity which combines religious 
instruction with medical advice ; and again, he comments 
on the popular instruction in hygiene which was supplied 
at that period to the English workingmen by a committee 
of competent physicians, organized for that purpose. It 
Was the author's purpose to collect and expand these letters 
into a volume, but the project was not carried out. 

The siege of Paris, which city he left in one of the last 
trains before the blockade commenced, and the prolongation 
of the war, induced him to return home. In the United 
States he found offers from several publishers awaiting hhn s 
which would more than occupy him for a full year. There 
was a new edition of his " Therapeutics " demanded, and a 
revision of both " The Physical Life of Woman" and " The 
Transmission of Life." A New England firm urgently 
pressed him to superintend the production of several hy=- 
gienic works, and secured him as literary adviser to their 
house. He assumed the editorship of the " Half- Yearly 
Compendium of Medical Science," and also of a " Physi- 
cian's Annual," besides undertaking a number of articles 
for the periodical press, both scientific and popular. 

To this active literary life he devoted the year 1871 ; 
but at its close felt more strongly than ever that he must 
give himself several years of studious quiet, in order 
to accomplish his best. Kefusing, therefore, any further 
engagements, he sailed for Europe again, late in 1871, and 
did not return this time until the spring of 1875. In this 



X BIOGRAPHICAL SKETCH. 

period, of more than three years, he visited almost all the 
principal cities of Europe, and enjoyed the friendship of 
many eminent men at London, St. Petersburg, Vienna, and 
Paris. Reading, visiting hospitals, and attending clinics, 
he accumulated a mass of material which he designed to 
work up into future literary enterprises. 

"With these collected stores he returned to the United 
States early in 1875, and set to work with his wonted en- 
ergy. A new and much enlarged edition of the " Thera- 
peutics" was sent to press ; a " Handbook of Popular Medi- 
cine," designed to give, in simple language, the domestic 
treatment of disease, the rules for nursing the sick, selected 
receipts for diet and medicinal purposes, and the outlines of 
anatomy and physiology, was put in the hands of a pub- 
lisher ; a Synopsis of Pharmacy and Materia Medica, a work 
of enormous labor, was well under way ; and other literary 
projects were actively planned ; when, suddenly, the sum- 
mons came which, in an instant, with the shears of fate, slit 
the strand of this activity. The rest of the story may be 
told in the words of the biographer appointed by the Medi- 
cal Society of the County of Philadelphia to prepare a me- 
moir of his life : — 

" While earnestly laboring to prepare for the press his 
literary collections, he suffered a severe blow by the sudden 
death of a person to whom he was deeply attached. - Over- 
work and this emotional shock produced a result likely 
enough to occur in one of his ardent temperament. One 



BIOGRAPHICAL SKETCH. XI 

afternoon, while engaged in writing, lie fell, unconscious, 
from his chair, and for several days lay in a very critical 
condition. On recovering his powers, it was evident his 
brain had suffered a. serious lesion. The old energy and 
love of labor had completely gone ; even the capacity for 
work seemed absent. Marked melancholy followed, charac- 
terized before long by avoidance of friends and the loss of a 
desire of life. This occurred with increasing force until it 
led to his death, on July 1, 1876, through some toxic agent, 
the nature of which was not ascertained. 

" Thus early, and thus sadly, terminated a career of un- 
usual brilliancy and promise. 

" It is probable that much that he has written will be 
read with pleasure and instruction by future generations ; 
and the memory of his genial disposition, his entertaining 
conversation, and earnest sense of professional honor, will 
long be cherished by those of his contemporaries who en- 
joyed his friendship." — Transactions of the Medical Society 
of the State of Pennsylvania, vol. xi, p. 720. 

Various tributes were paid to his memory by the societies 
with which he was connected, and by the scientific journals 
to which he had been a contributor. One of these, after 
narrating some of the circumstances attending his decease, 
spoke as follows : — 

" Thus did our unfortunate associate close his short but 
brilliant career. The emotions, the tender sentiments he 
has described with such a magical pen, he felt himself with 



Xll BIOGRAPHICAL SKETCH. 

an unmatched keenness. They mastered his whole frame 
with an intensity surpassing all romance. His descriptions 
of the passions, descriptions which have been the wonder of 
thousands, such is their fire and temper, were not rheto- 
rical studies, but the ebullition of a soul sensitive to their 
lightest breath, and not shunning their wildest tempests. 

" The genius which dictated the lines he has left us is 
not to be judged by the conventionalities which suit the cold 
temperaments of ordinary men ; there is a strong vein of 
egotism in most devotion ; but here was one who felt, ' all 
is lost, when love is lost.' " 

This extract well sets forth the extraordinary depth of 
his sentiments, and the fervor of his feelings. It may be 
added that these mental traits were not generally ascribed 
to him by casual or ordinary associates. He was, in man- 
ners and bearing, evidently not one who sought friendships 
or displayed to the general gaze the current of his thoughts. 
Consecmently, of intimates he had but few, and was consid- 
ered by those whose intercourse with him was superficial, 
to be much more of an intellectual than of an emotional type 
of character. 

This impression was doubtless increased by the strongly 
practical turn of his mind, which is conspicuous in all his 
works. He was the reverse of a dreamer and had little pa- 
tience with theorists. In his professional study he always 
aimed at bringing into the strongest light the utilitarian 
aspect of medicine, its ameliorating power on humanity, its 



BIOGRAPHICAL SKETCH. X1U 

real efficacy in preserving or restoring health and limiting 
human misery. On this his theory of therapeutics was 
based, and, inspired by the same opinions, he was one of the 
most earnest advocates of the day of popularizing medical 
science in all its branches among the masses. In this effort 
he was at times severely criticised by that class of physicians 
—and they are by no means extinct — who think that medi- 
cine should be wrapped in mystery, and that the people 
should be kept in ignorance of themselves and of their own 
physical frailties, to the utmost possible extent. With these 
learned obscurantists Dr. Napheys had no patience, and 
naturally found but slight favor. Fortunately, they were 
in the decided minority, and, we are happy to add, even that 
minority is daily decreasing. 

Of the various learned societies to which he was attached 
may be mentioned the Philadelphia County Medical Society, 
the Franklin Institute of Philadelphia, and the Gynecologi- 
cal Society of Boston. His election as Corresponding 
Member to the latter body (which is an association of 
scientific men who make an especial study of the hygiene 
and diseases of women) took place shortly after the first 
publication. of the Physical Life of Woman, and was meant 
as a direct tribute of respect to him as the author of that 
work, thus obtaining for it the testimony of the highest body 
in that specialty then existing in our land. 

The general plan on which Dr. Napheys prepared his 
sanitary writings was one eminently calculated to reconcile 



XW BIOGRAPHICAL SKETCH. 

those who were most opposed to instructing the general 
public in such" branches. While he confidently believed 
that vastly more harm than good is done by a prudish con- 
cealment of the physiology of sex and its relations to health, 
he also clearly recognized that such instruction should be 
imparted at the proper age and under certain limitations ; 
while the general fixcts common to the species cannot be 
taught too generally, or made too familiar. Hence, he pro- 
jected three books, one to be placed in the hands of young 
women, a second for youths, and a third for a general house- 
hold book of reading and reference on medicine and hygiene. 
These three he completed in " The Physical Life of Wo- 
man," " The Transmission of Life," and the " Handbook 
of Popular Medicine." 

This plan, he believed, met all the objections to popular 
medical instruction, at least all well-grounded objections, 
while at the same time it did away with any necessity for 
concealing truths important to be known, for fear they should 
come to the knowledge of those for whom they were not 
designed, and on whose minds they might have a disturbing 
tendency. 

There can be no doubt but that both the plan and its 
execution were successful. The many letters he received, 
filled with thanks from private parties who had gained ines- 
timable knowledge from these works, made rich compensa- 
tion for the occasional severe strictures he received from 



BIOGRAPHICAL SKETCH. XV 

those wedded to ancient ways, and who often condemned 
without even reading his works. 

The intelligent reading public, on whom, after all, the 
writer must depend for a verdict on his works, were unani- 
mous in his favor. They bought them in quantities, and the 
writer of his life in the Transactions of the Pennsylvania 
State Medical Society, above quoted, who wrote in 1877, 
estimates that by that time over a quarter of a million copies 
had been printed and sold. Translations were made into 
the German, and several editions pirated and printed in 
Canada and England. In fact, the works may now be con- 
sidered to rank as classics in the language, and many years 
must go by before another such series can be written, on 
topics of this nature, with equal delicacy of touch and accu- 
racy of knowledge. 



PUBLISHERS' PREFACE. 



In completing the excellent works of Dr. George H. Napheys 
on popular medical science, by the present volume, the pub- 
lishers believe that they present to the public a series of vol- 
umes unsurpassed in the literature of this department of study. 
The completeness of the present work, its practical character, 
its careful arrangement, and its fullness of illustration, make it 
unique of its kind. Of its high scientific and literary merit 
it is needless to speak ; for its plan and arrangement the reader 
is referred to the Introduction. 



CONTENTS. 



List of Illustrations, 17 

Introduction 21-23 

Part I. STRUCTTJBE AND ACTION OF THE BODY. 

CHAPTER I. 

THE FRAMEWORK OF THE BODY, AND ITS MOVEMENTS. 

PAGE 

Section I.— The External Coverings oe the Body. . . 26-32 
The Skin — Its structure and uses — How it regulates the heat 
of the body — How it drains off waste products — Its coloring 
matter — Hygienic hints on the care of the skin — Clothing — 
Dwellings— The Hair— The Nails. 

Section II.— The Flesh and Muscles , 32-46 

The structure of a muscle — Home gymnastic exercise without 
apparatus— Other forms of exercise. 

Section III.— The Bones and Joints 47-55 

The structure of bones — The four different classes of bones 
— The bones of the head— The bones of the trunk — The bones 
of the limbs — -The different kinds of joints — Deformities of the 
bones ; how avoided and remedied— The Teeth — Directions for 
their preservation. 

CHAPTER II. 

THE INSTRUMENTS OP THE BODY AND THEIR OFFICES. 

Section I.— The Air Passages and Organs 57-61 

The Lungs<— Their structure and use — What happens to the 
breathed air in the air tubes and cells^On ventilation — Sim- 
ple ways of changing the air in a room without draughts. 

Section II.— The Food Passages and Organs. . . . 61-66 
The manner in which food reaches the stomach — The process 
of digestion — The structure of the stomach and bowels- 
Classification of food — Practical directions for the corpulent 
for reducing flesh — How to become stouter — Appetite and 
hunger. 

ix 



x Contents. 

PAGE 

Section III.— The Blood Passages and Organs. . . . 66-72 
The structure and action of the heart— The course of the blood 
—The capillary vessels, what they are and how they act— The 
arteries and veins— The changes taking place in the blood, in 
the lungs, and in the network of small vessels— The office of 
the blood — How at the same time it nourishes and purifies the 
body. 

Section IV.— The Waste Passages and Organs. . . . 72-73 
The action of the lungs, the skin, and the kidneys, in remov 
ing the products of waste and decay. 

Section V.— The Special Senses 73-85 

The five gateways of knowledge— Of Smelling— How effected 
—The nose a respirator— Uses of the sense of smell— Its duties 
as a sentinel — Of Tasting — The mauner in which the impres- 
sion of taste is produced — The importance of pleasing the 
palate of the sick — Of Touch — The feelers of the skin — Of 
Hearing — The structure of the ear — How sound reaches the 
brain — Hints on the hygiene of the ear — Of Seeing — The 
structure of the eye — The offices of its different parts — A ray 
of light on its journey to the retina — Defects of the eye, their 
cause and prevention — Short sight — Long sight — Old sight. 

Section VI.— The Brain and Nerves 85-88 

The structure of the brain— Its office— The distribution of the 
nerves — Their office. 



Part n. SICKNESS IN ADULT LIFE. 

CHAPTER III. 

The Domestic Management of the Sick Room. . . . 90-102 
Choice of the Sick Room — Its furniture — Air and ventilation 
— Hints in regard to its warmth — How it should be lighted — 
The importance of cleanliness — Duties and deportment of those 
nursing the sick — Personal attentions required by the sick — 
Management of those recovering from sickness — Household 
remedies — Family thermometry. 

CHAPTER IV. 

AILMENTS AFFECTING THE WHOLE BODY. 

Section I.— Ailments Attended -with Fever as the Prom- 
inent Symptom 103-130 

Typhoid Fever— Typhus Fever— Bilious Remittent Fever— 



Contents. xi 

PAGE 
Chills and Fever— Break Bone Fever— Catarrhal Fever— Yel- 
low Fever— Sinall-Pox— Milk Sickness. 
Section II.— Ailments Attended with Pain as the Promi- 
nent Symptom ■ . . 130-141 

Neuralgia — Headache — Eheumatism — Gout — Lockjaw. 
Section III.— Ailments Attended with Sleeplessness as 

the Prominent Symptom 141-144 

Wakefulness — Delirium Tremens. 
Section IV.— Ailments Attended with Wasting- as the 

Prominent Symptom 144-150 

Starvation— Scrofula — Poverty of the blood— Night Sweats — 
Dropsy. 
Section V.— Ailments Attended with Insensibility as the 

" Prominent Symptom 150-153 

Fainting — Apoplexy. 
Section VI.— Ailments Attended with Fits as the Promi- 
nent Symptom. 153-155 

Falling Sickness — Hysterics — St. Vitus' Dance. 

CHAPTER V. 

AILMENTS OF PARTS OF THE BODY. 

Section I.— Ailments Seated in the Air Passages. . . 156-167 

Cold in the Head — Cold in the Chest — Sore Throat — Asthma — 

Pleurisy — Pneumonia— Consumption. 
Section II.— Ailments Seated in the Food Passages. . . 168-180 

Dyspepsia — Colic — Constipation — Diarrhoea — Dysentery — 

Cholera — Jaundice. 
Section III.— Ailments Affecting the Blood Passages. . 180-184 

Heart Disease — Swelling of Arteries. 
Section IV.— Ailments Affecting the Waste Passages. . 184-190 

Kidney Diseases — Diseases of the Bladder — Diabetes. 
Section V.— Ailments Seated in the External Cover- 
ings of the Body 190-199 

Diseases of the Skin— Of the Hair and Nails. 

CHAPTER VI. 

ACCIDENTS, INJURIES, AND POISONS. 

General Directions for Treating Accidents. . . . 200-201 
Bandages, Splints, and Dressings 201-204 



1 2 Contents. 

4k PAGE 

Bed Sokes 204 

Bites 205 

Of Mad Dogs— Hydrophobia, Babies— of Snakes— Spiders. 
Bleeding or Hemorrhage. ' 206 

From Wounds— from Nose — from Large Arteries. 
Boxes 211 

Broken— Out of Joint— (fractures and dislocations). 
Brain . . 222 

Compression and Concussion of. 
Bruises 222 

Blows — Contusions. 
Burns and Scalds 223 

Scars from. 



Cuts. 



225 



Drowned 225 

To Restore. 
Fainting and Faint Spells 230 



Falls. 



230 



Harts from. 
Frozen Persons 230 

To Restore— Frozen Limbs— Chilblains— Frost Bite. 
Railroad Injuries 232 

Spinal Shocks. 



Rings. 



232 



To get off. 
Ruptures, or Hernia 232 

Trusses. 

Scars 233 

From Wounds— Burns— Small-Pox. 

Shock 233 

Sprains and Strains .234 

Stings of Insects 235 

Stroke 235 

Sun-stroke— Heat-Stroke— Sun Headache— Sun Pain— Light- 
ning Stroke. 

Suspended Animation from Suffocation 237 

From Fixed Air, or Carbonic Acid Gas— Well Damp and 
Choke Damp— Charcoal Fumes— Common Burning Gas and 
Coal Gas— Strangulation— Hanging. 

Teeth Knocked Out -239 



Conte7its. 1 3 



PAGE 

Things 239 

In the Eye — in the Ear — in the Nose — in the Throat — in flie 
•Lower Bowel — in the Flesh — Needles — Pins — Fish-Hooks — 
Splinters or Thorns. 

Veins 242 

Swollen — Bursting of. 

Wounds. 243 

How to Dress — Bandages— Gunshot Wounds — Torn Wounds — 
Cuts-jStabs and Thrusts — Cut Throat — Scalp Wounds. 

Passive Movements 246 

For Wounds and Injuries — Illustrations of. 

Poisons and Poisonings 248-254 

General Directions — Acids, Mineral — Alcohol— Aconite — Am- 
monia — Antimony — Arsenic — Baryta — Belladonna— Bismuth 
— Bitter Sweet — Camphor— Copper — Corrosive Sublimate — 
Digitalis — Henbane — Iodine — Iron — Lead — Mushrooms — Ni- 
trate of Potash — Nitrate of Silver — Opium — Oxalic Acid — Poi- 
son Ivy, or Vine — Prussic Acid — Phosphorus — Savine — Stra- 
monium — Strychnia — Tobacco. 

Laying out the Dead . . 254 

Part III. SICKNESS IN CHILDHOOD. 

CHAPTER VII. 

DISEASES OP CHILDREN AILMENTS AFFECTING THE WHOLE 

BODY. 

Infantile Remittent Fever. ....... 256 

Wasting Fever — Gastric Fever — Worm Fever. 

Teething Fevee. 258 

Scarlet Fever 259 

Scarlatina — Scarlet Bash — Putrid Sore Throat. 
Measles. 262 

French Measles — Black Measles. 

Mumps 263 

Chicken-Pox, or Varicella 264 

Small-Pox, and Vaccination. 264 

Chorea, or St. Vitus' Dance. . 266 

Jaundice, or Yellows 266 

Worms, and Worm Troubles 266 

Hydrocephalus, or Water on the Brain 268 

Marasmus. . 269 

Wasting, or Decline. 



14 Contents. 

PAGE 

Scrofula. . 271 

Scrofulosis, or King's Evil — Management of Scrofulous 
Children — Hygienic Treatment. 

Rickets, or Rachitis 277 

Fits, or Convulsions 279 

Night Terrors, and Excessive Nervousness 282 

CHAPTER VIII. 

Ailments Affecting Parts of the Body. .... 284-305 
Snuffles— Stomatitis— Thrush— Sore Throat— Croup — Diph- 
theria — Whooping Cough — Coughs and Colds in Children — • 
Infantile Pneumonia— Colic — Summer Complaint — Falling 
of Bowel — Bed- Wetting— Weaning Brash— Milk Crust. 

CHAPTER IX. 

Accidents, Injuries, and Surgical Ailments of Children. 306-318 
Lancing the Gums — Tongue Tie— Hare Lip — Wry Keck — Sore 
Eyes — Cross Eyes— Ingrowing Eyelashes — Styes — Running, 
or Catarrh of the Ears— Earache— Crushed Fingers— Hip 
Disease— Spinal Diseases— Curvature of the Spine— Inflam- 
mation of the Spine— Dropsy of the Spine— Club Foot- 
Weak Ankles— Knock Knee— Rupture, or Hernia— Cancer — 
Swellings of the Glands of the Xe«k. 



Part IV. SPECIAL RECEIPTS FOR CARE OF THE 
SICK. 

CHAPTER X. 

DIETETIC RECEIPTS FOR THE SICK ROOM. 

Importance of the subject— Rules for preparing and serving 

food for the sick. 320-322 

Nutritious, Cooling, and Soothing Drinks. . . . 322-325 

Lemonade — Effervescing lemonade — Barley water — Linseed 
tea— Arrowroot drink— Milk punch— Wine whey— Egg and 
sherry— Ice — Toast and water — Nutritious coffee — Milk and 
Isinglass — A soothing drink — Milk and cinnamon drink — 
Caudle — Apple water — Chocolate — Chocolate milk — The In- 
valid's tea— Rose tea— Sage tea— Oatmeal tea. 

Gruels . 325 

Water gruel— Milk gruel— Flour gruel— Rice gruel— Barley 
gruel. 



Contents. xv 

PAGE 

Broths and Soups 326-327 

Chicken broth— Mutton broth— Whole beef tea— Quickly- 
made beef tea — Vegetable soup — Bread soup — Spinach soup — 
Beef and hen broth. 

Meats and Vegetables for Invalids „ 327-328 

Table, in order of digestibility, of some articles of animal 
food — Boiled pigeon or partridge — Bread sauce — Relish for 
fish — Minced fowl and egg — Fowl and rice — Stewed oysters — 
The invalid's cutlet — The invalid's mashed potato — Potato 
surprise. 

Jellies for Invalids 329-330 

Isinglass jelly — Strengthening jelly — Mutton jelly — Bread 
jelly — Rice blanc-mange — Arrowroot blanc-mange — Sago jelly 
— Tapioca jelly — Panada — Calves' feet jelly — Currant jelly 
— Irish moss blanc-mange — Gelatine blanc-mange. 

Puddings for Invalids 330-331 

Rice pudding — Bread pudding — Batter pudding — Milk for 
puddings or stewed fruit — Rice and apple— Vermicelli pud- 
ding. 

CHAPTER XI. 

MEDICAL RECEIPTS FOR THE SICK ROOM. 

Baths and Douches 333-336 

The hygienic importance of bathing — Rules for the use of the 
bath in health — Division of baths according to their warmth 
— The cold bath and directions for its employment — Warm 
and hot baths, when useful. 

Medicated Water Baths. . 336-339 

Soap bath — Bran bath — Starch bath — Oil bath — Alkaline bath 
— Valerian bath — Gelatine bath — Bark bath — Iron bath — 
Mustard bath — Salt water bath — Liver of sulphur bath — Tur- 
pentine bath — Vapor baths — Simple vapor bath — Medicated 
vapor bath — Warm air bath — Turkish bath — Russian and 
Roman baths — Fumigations — Shower baths — Douche baths- 
Sand and mud baths — Hip baths or sitz baths — Foot baths — 
Shallow baths. 

Cold Apfusion 337 

Wet-sheet packing — The drijoping sheet — The wet compress — 
The sponge bath. 

Blisters 339-340 

Cathartics or Purgatives . . 340-341 

Remarks in regard to their use — Receipts for Effervescing 
cream of tartar — Magnesia and rhubarb — E,hubarb and Epsom 



xvi Contents. 

PAGE 

salts— May apple— Jalap and cream of tartar— Calcined mag- 
nesia— Seidlitz powders— Purgative mineral water. 



Clysters or Injections. 



341-342 



A purgative injection— An astringent injection— Nutritive in- 



jections. 

Cold, Mode of Applying 34 ^ 

counter-irritants 342-343 

Cupping 3U 

Disinfectants 344-34S 

Emetics 34 ° 

Eye Washes or Waters 346 

Fomentations, or Stupes and Steaming 346-347 

Gargles U7 _ 

Heat, Mode of Applying 347-348 

Herb and other Medicinal Teas 348-350 

Receipts for. 

INHALATIONS 350 " 351 

Directions for Administering. 

Leeching 35 J nrA 

Liniments 353 " 354 

Lotions or Washes 3 ^ 3 ° 6 

Ointments or Salves fe6 

P\in Eemovers, or Anodynes 3o6-358 

POULTKES 358 " 360 

Bread and water poultice— Flaxseed meal poultice— Bran 
poultice— Stimulating poultices— Yeast poultice — Molasses 
poultice-Starch poultice— Charcoal poultice— Carrot poultice 
—Alum poultice— Mush poultice— Slippery elm poultice— Ar- 
rowroot poultice— Onion poultice— Mustard poultice— Bread 

and Milk poultice. 

m ... 360-361 

Tonics. .•••••••• 

Receipts fob the Hygiene of the Pebson 361-366 

Tooth powders-Mouth washes— Washes for foul breath-Hair 
tonics-Ointments and washes for dandruff-Lip salves and 
lotions— Ointments and washes for chapped hands— Ointment 
for fetid feet— Lotions for the face— Washes for removing 
freckles— Ointmeut for sunburn. 



•-370 



CONCLUSION. 

Charity to the Poor and Sick. 

THE FAMILY HEALTH RECORD. 

Appendix 371 - 3S8 

Index. 



LIST OF ILLUSTRATIONS. 



Internal Anatomy (colored). . . . Frontispiece 




THE EXTERNAL COVERINGS OF THE BODY. 




PAGE 


Pig. 1. 


Section of Skin ..... 27 


Fig. 2. 


Inside of a Hair ..... 30 


Fig. 3. 


Comparative Diagram .... 32 




THE FLESH AND MUSCLES. 


Fig. 4. 


Muscular Fibre ..... 33 


Fig. 5. 


Muscles about the Jaws .... 34 


Fig. 6. 


Knee-pan and Muscles .... 35 




HOME GYMNASTICS. 


Fig. 7. 


Movement 1 ..... 37 


Fig. 8. 


Movement 2 


37 


Fig. 9. 


Movement 3 


37 


Fig. 10. 


Movement 4 


38 


Fig. 11. 


Movement 5 


38 


Fig. 12. 


Movement 6 


38 


Fig. 13. 


Movement 7 


38 


Fig. 14. 


Movement 8 


39 


Fig. 15. 


Movement 9 


. . .39 


Fig. 16. 


Movement 10 


39 


Fig. 17. 


Movement 11 


39 


Fig. 18. 


Movement 12 


40 


Fig. 19. 


Movement 13 


. - . 40 


Fig. 20. 


Movement 14 


40 


Fig. 21. 


Movement 15 


41 


Fig. 22. 


Movement 16 


41 


Fig. 23. 


Movement 17 


41 



List of Illustrations. 



Fig. 


24. 


Fig. 


25. 


Fig. 


26. 


Fig. 


27. 


Fig. 


28. 


Fig. 


29. 


Fig. 


30. 


Fig. 


31. 


Fig. 


32. 


Fig. 


33. 


Fig. 


34. 


Fig. 


35. 


Fig. 


36. 


Fig. 


3 1 . 


Fig. 


38. 


Fig. 


39. 


Fig. 


40. 


Fig. 


41. 


Fig 


42. 


Fig. 


43. 


Fig 


44. 


Fig 


45. 


Fig 


46. 


Fig 


47. 


Fig 


48. 


Fig 


49. 


Fig 


.50. 


Fig 


51. 


Fig 


. 52 



Movement 18 
Movement 19 
Movement 20 
Movement 21 
Movement 22 
Movement 23 
Movement 24 
Movement 25 
Movement 26 
Movement 27 
Movement 28 

THE BONES AND JOINTS. 
The Thigh Bone— Example of the Long Bones 
"Wrist Bones— Example of the Short Bones 
Shoulder Blade— Example of the Flat Bones 
A Vertebra — Example of the Irreg'ular Bones 
Spinal Column 
The Chest Cage 
The Bones of tue Abdome 
The Skeleton 
The Permanent Teeth 
Tue Inside of a Grinder 

THE AIR PASSAGES AND ORGANS 
The Lungs .... 
Window Sash Ventilator 

THE BLOOD PASSAGES AND ORGANS 
Inside of the Heart 
Plan of the Circulation of the Blood 
Magnified Capillary Vessels 

THE SPECIAL SENSES. 
The Feelers of the Skin . 
Section of the Ear 
The Little Bones in the Ear 



List of Illustrations. 



Fig. 53. The Outer, Middle and Inner Ear 
Fig. 54. The Eyeball and Its Muscles 
Fig. 55. The Chamber of the Eye . 

THE BRAIN AND NERVES. 
Fig. 56. The Brain, Spinal Cord, and Neryes 

DOMESTIC MANAGEMENT OP THE SICK ROOM 
Fig. 57. Supporting Cradle 

BANDAGES AND DRESSINGS. 
Fig. 58. Bandaging a Leg with Adhesive Strips 
Fig. 59. A Koller Bandage 
Fig. 60. Bandaging a Leg . 
Fig. 61. A Four-tailed Bandage 
Fig. 62. A Many-tailed Bandage . 
Fig. 63. Irrigating a Limb . 
Fig. 64. Pressure to Check Bleeding from the Forearm 
Fig. 65. Pressure to Check Bleeding from Finger 
Fig. 66. Pressure to Check Bleeding at the Armpit 
Fig. 67. Pressure to Check Bleeding in Upper Arm 
Fig. 68. Handkerchief Tourniquet on the Arm . 
Fig. 69. Pressure on the Artery of the Thigh . 
Fig. 70. Handkerchief Tourniquet on the Thigh 
Fig. 71. Temporary Bandage for Fractured Limb 
Fig. 72. A Convenient Litter .... 
Fig. 73. Bandage and Sling for Collar-Bone Fracture 
Fig. 74. Bandage and Splints for Fracture of Uppei 

Arm ..... 

Fig. 75. Bandage and Splints for Fracture of Lower 

Arm ..... 

Fig. 76. Box for Broken Leg 
Fig. 77. Beducing a Jaw out of Joint 
Fig. 78. Bandage for a Collar-Bone out of Joint 
Fig. 79. Reducing an Arm out of Joint . 
Fig. 80. Reducing an Arm out of Joint without Assist 
ance 



92 

198 
202 
202 
203 
203 
204 
206 
207 
208 
209 
209 
210 
211 
212 
212 
213 

214 

215 
216. 
217 

218 
219 

219 



List of Illustrations. 



Fig. 


81. 


Fig. 


82. 


Fig. 


83. 


Fig. 


84. 


Fig. 


85. 


Fig. 


86. 


Fig. 


87. 


Fig. 


88. 


Fig. 


89. 


Fig. 


90. 


Fig. 


91. 


Fig. 


92. 


Fig. 


93. 


Fig. 


94. 


Fig. 


95. 


Fig. 


96. 


Fig. 


97. 


Fig. 


98. 


Fig. 


99. 


Fig. 


100. 


Fig. 


101. 


Fig. 


102. 


Fig. 


103. 


Fig. 


104. 


Fig. 


105. 



Reducing a Thigh out of Joint 
The Index Finger out of Joint 
The Clove Hitch . 
Reducing a Finger out of Joint 
Cupping back of Neck 
Extinguishing Flames on Clothing 

TO RESUSCITATE DROWNED PERSONS. 
Artificial Respiration . 
The First Movement 
The Second Movement 
The Third Movement 
The Sting and Poison Bag of a Bee 
Removing an Object from the Eye 
Bandage for an Injury to the Eye 
Dressing Ruptured Ham-string .. 
Applying Sticking Plaster 
Bandage for a Scalp Wound 
Passive Motion of the Trunk 
Passive Motion of the Chest and Abdomen 
Passive Motion of Limbs (Forward) 
Passive Motion of Limbs (Backward) 
DISEASES OF CHILDREN. 
A " Hip-bath " Tub for Children 
Lancing a Child's Gums . 

BATHS AND DOUCHES. 
A Home-made Bath Tub . 
A Home-made Shower Bath 

INHALATIONS. 

An Inhaling Bottle 



INTRODUCTION. 



Science has no secrets. Whatever it wins, it is ready to 
apply to the benefit of all, not retain for the profit of a guild 
or a profession. Its stores are bountifully open, and ignorance 
alone is barred from their use. To lessen this, to bring 
knowledge to the reach of all, to make every one acquainted 
with every fact he can profitably use — this is the high calling 
of the teacher. 

"What is thus true of science generally, is especially so of 
medical science. The health, the happiness, the life of man, 
are here concerned. What, his religious hopes excepted, has a 
more direct claim on his time, his mind, his money ? Yet the 
ignorance of the simple facts of anatomy, and of the proper 
action in time of accidents, is appalling. Too many of those 
who have set out to diminish it have failed through the use of 
pedantic terms, through the use of big words, and the writing 
of big books. 

The present volume is an endeavor to condense, in brief yet 
simple language, those remedial measures, those resources in 
emergencies which all should know, as well as the knowledge 
of the human body, which makes this information clear and 
available. It aims to do more than this, namely : to supply a 
volume of such a size that a traveler can have it always by 
him, containing instructions by which all the ordinary diseases 
of childhood, youth, and adult life can be properly treated by 



xxii Introduction. 

any intelligent person. Not that it is intended to take the 
place of a physician ; but where one who is reliable cannot be 
obtained, this work will prove a respectable substitute. Based 
on several of the most recent and able authorities, its recom- 
mendations will be found practical, and to the purpose. 

In one point, it will be found different from most, if not all 
other popular treatises on the subject, that is, the diseases 
peculiar to the sexes are omitted. The reasons for this were 
several. In the first place, by this omission, the present is a 
volume which need never be put under lock and key, but can 
and should always be kept on the family reading-table, where 
it can be consulted at any moment, and read whenever there 
is leisure for it; again, those diseases are so obscure that they 
cannot be sufficiently discussed in so brief a volume as this ; 
and lastly, they have been handled in full in the works, 
" The Physical Life of Woman " and " The Transmission of 
Life," both by the editor of this work ; the former treating of 
the diseases incident to the female, the latter, of those peculiar 
to the male sex. These works, published by the same house 
who publish the present book, are supplementary to it, and 
with it form a complete body of popular and practical Do- 
mestic Medicine. 

Great care has been tajsen that the arrangement of the 
present work should be clear, simple, and easy of reference. 
The diseases are classified : first, as those of adults and those 
of children ; secondly, under each of these heads, those ail- 
ments are first mentioned which affect the whole of the body, 
and next those which affect its several parts; again, under the 
first of these headings, that is, the diseases affecting the whole 
of the body, they are classified according to the most promi- 
nent symptom they display. By impressing on the mind this 



Introduction. xxiii 

scheme, the reader will find no difficulty in identifying an 
ailment which he may be called upon to treat. 

The medicines recommended have been carefully selected 
from the vast number which now fill the drug lists. Sim- 
plicity, cheapness and efficiency have been the guides here. A 
half dozen or so really excellent drugs are about all used by 
enlightened physicians in nine-tenths of their cases ; and the 
longer a physician practices, the fewer remedies he usually 
comes to employ. The receipts for a considerable number are 
given in Part iv, and referred to in the course of the work. 
In addition to them, prescriptions are added occasionally in the 
body of the book and several well-known preparations recom- 
mended. 

The pages of this volume which are devoted to the Family 
Health Record merit the attention of every mother. By ex- 
pending the slight labor necessary to fill them up, she will 
often render the physician more positive in his knowledge of 
her childrens' constitutions, and more certain, therefore, in 
his treatment, than by any amount of vague conversation. 



PART I. 
STRUCTURE AND ACTION OF THE BODY. 



THE DIVISIONS OF THIS PART. 

The body consists of a framework, and of instruments or "organs" 
within it. This framework is made up of the bones or " skeleton," 
covered by soft parts, and has its pieces so joined together as to 
enable us to move. These organs are instruments for performing 
the various acts essential to life. 

We, therefore, invite the reader first to the study of the frame- 
work of the hody and its movements, and then to that of the 
instruments of the hody and their offices, aiming to draw therefrom 
not merely dry facts and figures, for mental satisfaction, but practical 
lessons in health, for physical good. Fortified by the knowledge 
thus acquired, of the structure and action of the body, we can pass 
to the consideration of its more usual ailments, and of the manner 
in which they may be treated and avoided. 

" Not in the world of light alone, 
Where God has built His blazing throne, 
Nor yet alone on earth below, 
With belted seas that come and go, 
And endless isles of sunlit green, 
Is all thy Maker's glory seen — 
Look in upon thy wondrous frame, 
Eternal wisdom still the same ! " 

3 -25 




S*!i^5 



3fcS32^Sis^*%V< 




CHAPTER I. 



THE FRAMEWORK OF THE BODY, AND ITS MOVEMENTS. 

Section I.— The External Coverings of the Body.— The Skin— 
Its structure and uses — How it regulates the heat of the body — How it 
drains off waste products — Its coloring matter — Hygienic hints on the 
care of the skin — Clothing — Dwellings — The Hair — The Nails, 

Section II.— The Flesh and Muscles.— The structure of a muscle- 
Home gymnastic exercises without apparatus — Other forms of exercise. 

Section III.— The Bones and Joints.— The structure of bones— The 
four different classes of bones — The bones of the head — The bones of the 
trunk — The bones of the limbs — The different hinds of joints — Deformi- 
ties of the bones ; how avoided and remedied— The Teeth— Directions 
for their preservation. 

The skin, which, with its outgrowths, the hair and the nails, 
makes up the external covering of the body, envelops the flesh and 
muscles, which, in turn, clothe the hones. Starting with the de- 
sign of proceeding in our study from the best known to the least 
known, from the seen to the unseen, we shall first turn our attention 
to the external coverings, and then direct our course to the inner 
and deeper mysteries of that wonderful structure we call "the 
body." 



I. The External Coverings or the Body. 



The body is covered by the skin and its outgrowths, the hair and 
nails. The skin is a membrane of greater or less density, envelop- 
ing the entire surface of the body. It serves the purpose of pro- 
tecting the parts lying beneath, of regulating the animal heat, 
of affording an outlet for waste and used-up matters, and of estab- 
lishing sensitive relations between the living frame and surrounding 
It is the principal seat of the sense of touch. The tissue 
26 



The External Coverings of the Body. 



27 



of the skin is compact, but pierced by numerous passages. It con- 
sists of two layers, the scarf skin and the true skin, the latter of 
which, when prepared by the chemical process of tanning, consti- 
tutes leather. Figure 1 shows the side, greatly magnified, of a cut 
made through the skin. , Nos. 1, 2 and 3 are the scarf skin; 8, the 
true skin ; 4, the coloring matter of the skin ; 6, nipple-like emi- 
nences, by which we have the sense of touch ; 7, sweat glands, with 
ducts or tubes, 9, passing through the true skin and the scarf skin, 
to the pores on the surface, 11, to throw out perspiration. 

The skin is the great heat regulator of 
the body. This it accomplishes by increas- 
ing the sweat when the body is too hot, and 
by lessening it when it is cool. But it will 
be asked, how does this increase of sweat 
reduce the animal heat? Very simply. 
All fluids as well as solids possess two forms | 
of heat : one of which is not perceptible to , 
the touch or thermometer, and therefore 
termed latent or hidden; while the other] 
can be detected by the touch and measured I 
by the thermometer. But a gas or vapor , 
has many (almost seven hundred) times as 
much latent or hidden heat as a fluid, hence, 
when the water of the perspiration is ; 
poured out upon the skin and becomes i 
vapor, it absorbs heat from the skin and 
blood, and so cools us off. 

When we are quiet the skin has little moisture upon it, but when 
we exert ourselves violently the water trickles from the surface, and 
by its evaporation, rids us of unnecessary heat. We are thus en- 
abled, also, to resist unnaturally high temperatures, as well as very 
low ones. So long as the air be dry very great heat can be borne. 
In some trades workmen enter furnaces the air of which has a 
temperature of a hundred and fifty degrees above that which boils 
water. Under these circumstances the sweat glands are stimulated 
to extraordinary activity, and pour . out a large quantity of water 
upon the skin, which quickly evaporates, and so cools down the body 




Section of Skin. 



28 Structure and Action of the Body. 

to the natural temperature. If, however, the air he moist instead 
of dry, and if sweating he in any way interfered with, the body 
soon becomes unnaturally warm, and death results if the exposure 
be long continued. 

The process of perspiration goes on Without our aid or will, but 
is effected by variations in the temperature, by exercise, by various 
nervous conditions, such as anxiety, excitement, irritation or lassi- 
tude, and may be controlled, to a great extent, by the amount of 
clothing we wear, or of the fuel we put in our stoves. The total 
number of sweat pores reaches the enormous sum of seven millions, 
and the total length of the sweat tubes of the body is nearly 
twenty-eight miles. 

This vast array of tubes and pores not only serves to regulate the 
temperature of the body, as we have just explained, but also to give 
an outlet to the products of the waste of the system, and thus aid the 
kidneys, which are apt to become disordered wben anything inter- 
feres with the free action of the skin. Some animals, as frogs and 
salamanders, breathe largely through the skin as well as the lungs. 
In these animals the skin is veiy moist, flexible, and copiously sup- 
plied with blood vessels. While the animals are beneath the surface 
of the water, and therefore unable to breathe by the lungs, respira- 
tion takes place through the skin. We also breathe by the skin, 
but to a much more limited extent. This enables us to understand 
the desirableness of keeping the skin moist in fevers, in which there 
is great heat and dryness of the surface, since the breathing process 
cannot go on through a dry membrane. Cold and tepid sponging 
affords, therefore, in these cases, much relief. The myriads of 
sweat glands and pores, and the miles of sweat duets, also teach us 
the importance of proper exercise to stimulate them into action, and 
of personal cleanliness to remove the matter thrown out. Many 
diseases are consequent upon inactive habits of life and want of 
ablution. 

The color of the skin is determined by the tint of the layer of 
coloring matter found between the scarf skin and the true skin, as 
shown by No. 4, in Figure 1. Here we have the seat of the varied 
hues which characterize the different races of men, as, for example, 
the fair and ruddy Saxon, the jet-black Negro, the olive Mongolian, 



The Skin Affected by Climate. 29 

and the copper-colored Indian. Eedness of the cheeks is almost 
wholly confined to the white races. "It is only," writes Humboldt, 
"in white men, that the instantaneous penetration of the skin by 
the blood can take place, that slight change of color which adds so 
powerful an expression to the emotion of the soul. 'How can 
those be trusted, who know not how to blush?' says the European, 
in his inveterate hatred to the negro and the Indian." Still, in 
some very light examples of the brown and yellow races, blushing 
has been observed. Climate has a great influence over the com- 
plexion. The fairer races live remote from the tropics. People 
inhabiting high mountains and countries of great elevation, are 
generally of a lighter color than those living upon a lower level, 
such as swampy or sandy plains at the seaside. Albinos, or those 
whose skin is of an unnaturally white tint, are found among the col- 
ored as well as in the white races, so that there are white negroes 
and white red men. There are several authentic cases upon record 
of change of color in the negro, the change being so complete that, 
at least in one instance, that of a negro who was perfectly black 
until the age of twelve, "but for his hair, which was crisped or 
woolly, no one would have supposed that his progenitors had offered 
any of the characteristics of the negro, his skin presenting the 
healthy vascular appearance of that of a fair-complexioned Euro- 
pean." The artificial colors imparted to the skin by tattooing, so 
frequently seen among sailors, and of which such curious and often 
very elegant examples are found among the South Sea Islanders, 
are indelible, residing as they do in the true skin, and can only be 
removed by the destruction of the part. They may, however, be 
concealed, for a time at least, by pricking in over the marks a fine 
rouge of the exact color of the skin, repeating the operation when 



Hairs are found upon almost every portion of the surface of the 
body, except the palms of the hands and the soles of the feet. A 
hair is composed of a bulb or root, which is the part imbedded in the 
skin ; of a shaft, which is the free portion ; and of a point. In figure 
2, there is shown the inside of a hair, by which it will be seen to be 
a delicate tube. The minute canal there pictured is filled with air. 
The walls of the hair tube are double, the outer coat consisting of 
3* 




30 Structure and Action of the Body. 

flat scales, the inner coat of cells which contain the coloring matter. 

The surface of each hair is therefore covered hy minute scales, like 

those of a fish. They overlap each other from root 

to point, which is the reason that a hair, when drawn 

through the fingers from the root to the point, feels 

smooth, hut rough when drawn from point to root. 

The number of the hairs on a healthy head have been 

calculated to be over a hundred thousand. The hair 

of the head grows at the rate of about eight or ten 

inches a year. The influence of the mind upon the 

.. color and growth of the hair of the head is well known, 

'v fl iar ) anxiety, and dismal emotions weakening it and 

turning it gray. Usually, the change in color is 

HP? gradual, but authentic instances are on record of the 

inside of a hair, j^ burning gray in a single night 

" A tedious night indeed, that makes a young man old." 
The subject of hair washes and tonics will occupy us in their 
proper place, in accordance with the plan of the book, and can be 
found by reference to the index. 

The Nails are situated, as we all know, upon the backs of the 
ends of the fingers and toes. Each nail consists of a root, the part 
imbedded in a groove of the skin ; of a body, and of a free edge. 

We are much less protected than animals, by natural coverings, 
against the vicissitudes of weather, and the rigors of inhospit- 
able climates. They are furnished with hair, fur, or feathers, of 
such a quantity and color as to enable them to bear different temp- 
eratures and climates. We are endowed with reasoning powers 
which teach us how to clothe and house ourselves, in order to guard 
against the various degrees of heat and cold we encounter. A few 
words upon the hygiene of clothing and dwellings may here be in 
place. 

Clothing. For the under-clothing, woolen is preferable all the 
year round, from infancy to old age — heavy flannels for the winter, 
light merinoes for the summer. Muslin next the skin is warmer than 
linen, which should never be so worn, as it tends to give cold by the 
sensation of cold it imparts after the body has been heated and 



Hygiene of Clothing and Dwellings. 31 

thrown into a perspiration. For the outer-clothing, a cloak, over- 
coat or shawl, which should also be of wool, is necessary to be worn 
or thrown aside, according to the weather and the feelings. For the 
intermediate clothing, the quality and quantity are determined by 
the manner of living, the occupation, and the season of the year. 
Wool is best for cold weather; cotton goods and silk may be worn 
at other times by women, and linen, perhaps, by men. We see, 
therefore, that woolen fabrics make the best article of clothing, for 
outdoor and indoor wear, and for all seasons. The clothing at night 
should also be of wool, as heavy cotton counterpanes weigh the body 
down and cause great fatigue. The coverings of the bed, therefore, 
except the sheets, should all be blankets. The number of blankets 
used must vary with the state of the health, the sick and feeble 
requiring greater warmth at night than the well ; with the age, old 
people and children needing more night clothing than those in 
middle life ; and, naturally, with the weather and season. When a 
woolen night dress is worn, which is preferable to a muslin one in 
cold weather, and particularly for the very young and aged, and 
those subject to rheumatism, fewer blankets will be required. Per- 
sons with cold feet are usually more comfortable with woolen stock- 
ings. Two light stockings are warmer than a single heavy one. 
Great care should be taken to keep the hands and feet of aged 
persons warm. Inattention to the clothing of very old people and 
•infants, who are alike sensitive to cold, is a frequent cause of death 
in winter. 

A dwelling should be in a healthful locality, dry, light, well ven- 
tilated and roomy. Its site should be dry and high. The soil 
should be either impermeable or permit of the rapid passage of 
water. A house on a hill is usually less cold in winter, and cooler 
in summer than one lying in a neighboring valley. Damp soils and 
made ground are to be avoided in building. A clay soil is cold, wet 
and unhealthy, unless thoroughly drained. Grass land about a 
house is better than arable, both summer and winter. Brick makes 
a dryer and warmer building material than stone or wood. No 
garbage, heaps of rubbish, or filth of any kind should be permitted 
near the house. No waste pit, cesspool, privy, surface nor under- 
ground drain should go close to a well ; neither should slops or 



32 



Structure and Action of the Body. 



dish-water be thrown near it, for fear of fouling the water. Every 
house should have a cellar, with windows, under the whole of the 
lowest, and a garret or attic, with windows, over the whole of the 
highest story. Rooms ought to be made of a size to permit of 300 
cubic feet, at least, to each occupant. Figure 3 shows a room 15 
Fig. 3. 



_U 




feet long, 10 wide, and 10 high. In the 1500 cubic feet that it 
contains five persons might live, if the room were well ventilated. 
The size of a man in the room, and the bulk of the air (14 cubic 
feet) which he breathes every hour, are shown in proportion. 500 
cubic feet to a person, or three persons in such a room, is a better 
allowance than 300 cubic feet to a person. This subject of pure air 
and ventilation will be discussed in speaking of the air passages and 
organs. No room should be without sun a part of the day. For this 
reason, and because it is a cause of dampness, thick foliage closely 
about a house is to be avoided. 



II. The Flesh and Muscles. 



The word flesh is applied to every soft part of the body, but 
more especially to the muscles, which are often called muscular 
flesh. The muscles of animals constitute the lean of the meat which 
is served up to us as food. They are the active agents of motion 
in the body, the means by which all our movements are effected. 
They act like cords attached to levers, and work according to strict 
mechanical principles. As our movements are diverse and com- 
plex, our muscles are numerous, there being about four hundred of 



The Flesh mid Muscles. 



33 



them. Most of them are under the command of the will, being set 
and kept in motion at our pleasure, and are therefore called volun- 
tary muscles. Such, for instance, are those by which we move our 
limbs. Many of them, however, are entirely beyond the control of 
the will, it being utterly impossible for us to put or keep them in 
motion in accordance with our wishes, and are, therefore, called in- 
voluntary muscles. Such, for instance, are those of the heart and 
stomach. Still, over some of these involuntary muscles the will 
exerts a partial control. Though we cannot hasten, lessen, nor stop 
altogether the beats of the hollow muscle forming the heart, we can, 
to a limited extent, quicken or suspend the action of the muscles 
which enable us to breathe ; though we are unable to control the 
movements in the walls of the gullet, stomach and bowels, by which 
food is carried along the digestive tract, we can to a certain extent 
interfere in the acts of swallowing and vomiting. The most im- 
portant actions. of the system, the circulation of the blood, and the 
digestion of food, for instance, are performed by the involuntary 
muscles. This is wisely ordained, like all the other operations 
within us. If such nice complicated movements, 
upon which our lives depend, were left to the mm 
direction of our minds, they would occupy too much |jjj 
of our attention, and be naturally neglected during jlj 
sleep. We are, happily for ourselves, restricted in m 
our control to those muscular movements which J] 
can be easily performed, and which do not require 1 1 
to be constantly and regularly kept up in order to ' | 
maintain life. I 

The muscles are fleshy bodies, of various lengths 1 
and sizes. They are formed of fibres, and con- 
nected with the bones by means of sinews. The 
involuntary muscles are unconnected with bones. 
Figure 4 shows the striped fibre of a voluntary 
muscle. The muscle consists of bundles of such I 
fibres, made up of hundreds of smaller fibres, as 
shown at B. The striped or crossed lines, which 
characterize voluntary muscles, are shown at A. In- |{ill!PBll 
voluntary muscular fibre is smooth, without stripes. Muscular Fibre. 



Fig. 4. 



B 



ill 



■■■ a 



34 



Structure and Action of the Body. 



The voluntary muscles pass from one bone to another, con- 
nected with it by a joint, so as to permit the one to move upon the 
other, like a hinge or a ball and socket. That end of the muscle 
which adheres to the most fixed part, is called the origin or head; 
the extremity which adheres to the more movable part, the inser- 
tion or tail ; the intervening part or body being called the belly of 
the muscle. The muscles possess the power of shortening or con- 
tracting themselves, and, as a necessary consecpience of this diminu- 
tion of their length, move in various directions, upon their joints, 
the bones to which they are attached. All the motions of the body 
are, in this manner, performed by the combined action of the various 
muscles. Thus in eating, the under jaw, by the shortening which 
takes place in accordance with our wish, of one set of muscles, is 
drawn up with force, so that the food is crushed and ground by the 
lower against the upper teeth ; this shortening lasts but for a moment, 
the muscles are then relaxed, and another set draws the jaw down. 
These movements go on with rapidity while we continue eating. 
The muscles which move the jaw and lips are seen in Figure 5. 
Nos. 9, 10 and 11, are those 
which lift the angle of the 
mouth; 12 and 13 those which 
draw the mouth downward; 
18 that which draws the mouth 
backward and presses the food 
between the teeth; 15 the 
strong muscle drawing the jaw 
upward and backward ; 22 and 
24 that which opens the mouth. 
In the sinews of some mus- 
cles, little seed-like bones are 
sometimes developed. They 
occur near the joints, particu- 
larly of the toes and fingers, 
Muscles about the Jaws. and are more numerous in men 

than in women. The object of these little bones is to allow the 
sinew to attach itself at a greater angle to the bone the muscle is 
designed to move, and thus increase its leverage power. The best 



Fig. 




The Wonders of the Muscular System. 



35 



example of a development of this kind is seen in the knee-pan, 
seated in the sinew of the great muscle which extends the leg. 
This is well displayed in Figure 6. 
The marvelous beauty of 




our muscular organization is 
best shown, not by the opera- 
tion of a single muscle, won- 
drous though it be in its 
simplicity and completeness of 
means to end, but by the sym- 
metry and harmony of com- 
bined muscular movements. 
The perfection of our organi- 
zation, in this respect, is re- 
markably evinced by the fact 
that no machinist, however 
ingenious, has ever yet suc- 
ceeded in building up an au- 
tomaton which can walk like 
a man. Yet we are able to go 
through the whole series of 
complex movements necessary 
in walking, so readily, as to be 
scarcely conscious of an effort. 

The muscles of different animals, and their limbs, are adapted, by 
their situation and shape, to the particular kinds of motion their 
mode of life requires. Thus, in monkeys and apes, who climb trees 
for their food and to escape beasts of prey, the limbs are especially 
fitted for climbing, and they go with difficulty on the level ground, 
either on four legs or two. 

The rapidity with which muscles can shorten and relax their 
fibres, is almost inconceivable. Thus, by the movements of the 
tongue, and other instruments of speech, fifteen hundred letters can 
be distinctly pronounced in a minute by some people ; the production 
and cessation of these sounds require one or several muscles to 
contract upon themselves fifty times in a second. It has been 
calculated that in the legs of a dog, running at full speed, muscular 



Knee-pan and Muscles. 



36 Structure and Action of the Body. 

contractions take place twelve hundred times in a second, for many 
minutes together. The wings of many insects, it is well known, 
strike the air several thousand times a second, producing, by the 
rapidity of their vibrations, a musical note. The power of motion 
possessed by animals is proportioned to their weight and structure. 
Could an elephant or a horse leap several hundred times its own 
length, as a flea can, its weight would crush it to atoms. 

Muscles increase in size and in strength as they are exercised, a 
fact illustrated by the arm of the blacksmith and the leg of the 
ballet dancer. We see, therefore, the importance of gymnastic ex- 
ercise in order to develop the different classes of muscles and to 
make the body more agile and adroit, and thus more useful to us. 
But gymnastic exercises recommend themselves for other and 
higher reasons than the purpose of securing huge muscles and 
great adroitness of movement. They expand the chest, rid us of 
superfluous water and fat, excite the action of the skin and lungs, 
improve the digestion and give tone to the nervous system. In 
order to obtain full benefit from these, the attention should not be 
directed chiefly to the attainment of great strength, or even of 
superior agility. Many practiced gymnasts, while getting and 
keeping up enormous muscles and the ability to perform feats of 
astounding agility, ruin their health. Strength and health do not 
always go hand in hand. Great moderation and judgment are 
necessary in order to avoid over exciting the action of the heart and 
lungs, and by excess, inducing exhaustion and disease, rather than 
health. For family use, a scheme of gymnastics is necessary which 
may be carried out without danger, and without apparatus, in 
which nature herself is made to furnish the means of self-improve- 
ment. With this object in view, we give below a series of simple 
but well studied movements, a succession of efforts at once gentle 
and energetic, of which each has its reason and object. Let no 
one smile at the apparent insignificance of certain of the move- 
ments. They are all grouped so as to form a complete system of 
home exercise for children and adults, and for both sexes. Greater 
amusement, and perhaps benefit will be afforded by a number going 
through the movements together like soldiers under command, 



Exercise without Apparatus. 37 

and even to the accompaniment of music. But no class is neces- 
sary ; every one can exercise himself. 

There are few who would fail to derive a benefit which would 
astonish them, from devoting twenty minutes daily to these gradu- 
ated exercises. They also form excellent means for the physical 
education of children. 



FIRST MOVEMENT. 

Place the Lands upon the hips, the heels 
together, the toes turned out. Turn the head from 
right to left (six times in each direction), counting 
one, two. The head should be turned so as to 
carry the chin nearly directly over the shoulder. 
Bring the head to the front and rest a moment. 



SECOND MOVEMENT. 

Bend the head to the right and then to the left 

(six times in each direction), counting one, two. 

At one, incline the head toward the right shoulder ; 

at two, raise it and repeat the movement toward 

the other shoulder. 



THIRD MOVEMENT. 

Carry the head forward and backward (six 
times), counting one, two. 

At one, lower the head on the chest; at two, raise 
it and carry it backward. 



Fig. 7. 




Movement 1. 



Fig. 8. 




Movement 2. 



Movement 3, 



38 



Structure and Action of the Body. 



Fig. 10. 



FOURTH MOVEMENT. 

Turn the body to the right and then to the left 
(six times), counting one, two. 

At one, turn the trunk and upper part of the 
body toward the right, keeping the legs fixed ; at 
two, repeat the same movement in the opposite 
direction. 



Movement 4. 
Fig. 11. 





FIFTH MOVEMENT. 

Bend the trunk to the right and then to the 
left (six times), counting one, two. 

At one, bend the trunk toward the right, with- 
out changing the position of the axis of the body ; 
at two, bring it upright and repeat the movement 
in the opposite direction. ]So stopping between 
movements. 

SIXTH MOVEMSNT. 

Incline the body forward and bend it backward 
(six times), counting one, two. 

At one, incline the body forward without bending 
the knees; at two, straighten it and carry it back' 
ward, drawing in the shoulders. 



The above six movements 
through with slowly. 



should be gone 




SEVENTH MOVEMENT. 

The fists against the chest, extend the arms up 
vertically (six times), counting one, two. 

At one, jerk the arms into the air, the hands 
clenched, the thumbs within. At two, return the 
arms to the chest. 



Movement 7. 



Home Gymnastics, 



39 



Fig. 14. 



EIGHTH MOVEMENT. 

Strike the arms out horizontally forward (six 
times), counting one, tioo. 

At one, thrust the arms out, side by side, 
directly in front; at two, draw them quickly back 
to the chest. 




NINTH MOVEMENT. 

The hands being brought near to- 
gether on the chest, throw the arms 
horizontally outward and backward 
(six times), counting one, two. 

At one, extend the arms, in arching 
slightly the chest; at two, bring them 
back to the chest. 



TENTH MOVEMENT. 

The wrists being crossed on the back, bend the 
(six times), counting one, two. 

At one, bend slowly the knees, holding the 
body straight; at two, rise without uncrossing the 
arms. 



ELEVENTH MOVEMENT. 

The arms being dropped along the sides of the 
body, bend the knees and extend the arms forward 
(six times), counting one, two. 

At one, bend the knees, resting on the soles of 
the feet, and at the same time extend the arms 
horizontally forward; at two, rise, bringing the 
arms back to the sides of the body. 



Movement 8. 
Fig. 15. 



::^m 




Movement 10. 
Fig. 17. 




4 o 



Fig. 18. 




Structure and Action of the Body. 

TWELFTH MOVEMENT. 

The legs being stretched apart, the arms in the 
air, balance the body (six. times), counting one, 
two. 

At one, bend the body forward and throw the 
arms quickly between the knees ; at two, raise the 
body and extend the arms above the head. This 
movement ought to be made with suppleness. 
Now bring the feet together and the arms to the 
sides, and rest a minute. 



Movement 12. 




THIRTEENTH MOVEMENT. 

The arms being behind the back and the hands 
closed, raise the arms vertically (ten times), count- 
ing one, two. 

At one, carry the arms, extended, in front of 
the face, to a straight, vertical position above the 
head; at tioo, bring them back cmickly to the 
starting position. 



Movement 13. 




FOERTEEXTH MOVEMENT. 

The hands being open, raise the 
arms sideways * (ten times), counting 
one, tico. 

At one, raise the arms, extended 
from each side, to the vertical position, 
above the head; at two, let them fill 
to the side of the body, without bend- 
ing the elbows. 



Movement 14. 



Health Movements. 



41 



FIFTEENTH MOVEMENT. Fig. 21. 

The right foot being advanced, and 
the left leg well stretched, turn the 
left arm around with the windmill 
movement (ten times), counting one, 
two, three, etc. 

At one carry the left arm backward 
and then forward, by a circular move- 
ment, counting two on the second 
revolution, three on the third, etc., 
until ten turns have been made with- 
out stopping. Then repeat the same manoeuvre for 
the right arm, the left foot being advanced. 




Movement 15. 

Fig. 22. 



SIXTEENTH MOVEMENT. 

The hands being on the hips, raise alternately the 
1 (ten times), counting one, two, three, four, etc. 

At one, bend the right leg and lift it towards the 
chest; at two, lower it; at three and four, repeat 
the same exercise with the left leg. 

SEVENTEENTH MOVEMENT. 

The hands being on the hips, extend the legs 
alternately, straight out, as nearly as possible, in 
front (ten times), counting one, two, three, four. 

At one, extend the right leg, nearly horizontally, 
in front; at two, bring it back to place; at three 
and four, repeat the same exercise with the left 



Movement 16. 
Fig. 23. 



: --~-K? 



EIGHTEENTH MOVEMENT. 

The hands being on the hips, carry 
the legs alternately backward (ten 
times), counting one, two, three, four. 

At one, throw the right leg back- 
ward, in bending lightly the left knee, 
and slightly leaning forward ; at two, 
bring it to place and straighten the 
body; at three and four, repeat the 
same exercise with the left leg. 
4* 



Movement 17. 
Fig. 24. 




42 



Structure and Action of the Body. 



Fig. 25. 




Movement 19. 



NINETEENTH MOVEMENT. 

The hands being on the hips, throw 
the right leg from the side (six times), 
counting one, two. 

At one, turn the toes of the right 
foot out, and throw the right leg out- 
ward, in turning slightly the head to 
the same side ; at two, bring the leg 
back, keeping the toes out. Repeat 
the same exercise with the left leg. 



Fig. 26. 




Movement 20. 



TWENTIETH MOVEMENT. 

The hands being on the hips, stretch 
out the legs alternately in front (ten 
times), counting one, two, three, four. 

At one, lift the right bended knee 
toward the chest; at two, extend the 
leg in front; at three, rebend the knee; 
at four, return to place. Repeat the 
same exercise with the left leg. 




TWENTY-FIRST MOVEMENT. 

Carry one foot forward and revolve 
both arms backward together, at the 
side of the body (ten times), counting 
one, two, three, etc. 

The motion is to be kept up without 
stopping, counting two at the second 
turn, three at the third, up to the 
tenth. 



Movement 21. 



Physical Education. 



43 




Movement 22. 



:3 



TWENTY-SECOND MOVEMENT. 

Carry the right foot forward, and 
revolve the arms at the sides, in oppo- 
site directions (six times), counting 
one, two, three, etc. 

At one, carry the right foot forward, 
bending the knee, elevating at the 
same time the right arm in the air, 
and extending the left backward. At 
two, revolve the arms forward, the 
right arm descending in front, while 
the left is rising behind, by a continued circular movement. Count 
one at each turn of the arms, to ten. 

TWENTY-THIRD MOVEMENT. 

The right hand being at the left 
shoulder, and the left arm stretched 
out horizontally well back, throw the 
arms around the body (six times), 
counting one, two. 

At one, carry the right hand, closed, 
to the left shoulder, and extend the 
left arm horizontally, well back; at 
two, throw the arms horizontally about Movi 

the body, from left to right and from right to left, 
a semicircle. 

This exercise should be executed with sufficient vigor to impress 
upon the trunk a rotation movement upon the hips. The legs 
should rest immovable. 

TWENTY-FOURTH MOVEMENT. 

The right foot being in advance, 
and the two fists against the sides of 
the chest, thrust the two arms straight 
forward, and then carry them outward 
and backward, always extended (six 
times), counting one, two, three, etc. 

At one, carry the closed fists to the 
chest; at two, thrust them quickly , -, ,. 




to describe 




44 



Structure and Action of the Body. 



forward; at three, carry them outward and backward, always 
extended horizontally, the head being thrown back. 

Fig. 31. TWENTY-FIFTH MOVEMENT. 

The charging step in fencing (six 
times), counting one, two. 

At one, make, quickly, a long step, 
obliquely to the right, carrying, at the 
same time, the left arm upward and 
backward, and bending it slightly, so 
that the wrist will be above the level 
of the head, and throwing forward the 
Movement 25. right arm, extended without stiffness. 

It is the movement of the right arm, indicated by the dotted semi- 
circle in the figure, which swings the whole body to the right. At 
two, return with vivacity the right leg to the side of the left, and 
let the arms fall by the side. Repeat the same movement to the left. 




Fig. 32. 




Movement 26. 



TWENTY-SIXTH MOVEMENT. 

Throwing oneself forward, first on 
the one, then oh the other leg, in 
elevating the arms in the air (ten 
times), counting one, two. 

At one, make a long stride forward 
with the right foot, throwing the arms 
above the head backward, bending the 
right knee, and extending energetically 
the left leg; at two, bring the right 
Repeat the 



leg back to position, and let the arms fall to the sides. 
same exercise with the left leg. 
Fi 




Movement 27. 



TWENTY-SEVENTH MOVEMENT. 

Bending and throwing the whole 
body forward (six times), counting 
one, two, three. 

At one, make a long stride forward 
with the right foot, as in the preced- 
ing movement; at two, bend the body 
over the right leg in letting the hands 
fall to the floor; at three, raise the 




He alt J if id Exercises. 45 

body in describing a large circle with the arms, and without bend- 
ing the left leg. The arms should be brought up side by side, and 
without any bending, to above the head, and there separated to 
describe their circle, in being brought down to the sides. Repeat 
the same exercise with the left leg in advance. 

TWENTY-EIGHTH MOVEMENT. Fig. 34. 

Separating the legs and bending the 
body to the right and left, in four 
motions (six times), counting one, two, 
three, four. 

At one, raise the arms vertically in 
the air, and extend them well back ; 
at two, turn the trunk of the body 
only, and bend over and down to the 
right, letting the arms fall in front 
until the fingers touch the right heel ; 
at three, rise, with the arms above the head, as at first ; at four, turn 
the body on the hips to the left, and repeat the movements just 
made, to the right. 

Other Forms of Exercise. — Walking is a convenient and 
excellent mode of exercise within the reach of all. A walk, as long 
as can be taken short of fatigue, a couple of hours after breakfast, 
or two hours before sunset, with some object in view, in easy shoes 
sufficiently thick to keep the feet dry, is an admirable " constitu- 
tional," as the English call the daily promenade. Horseback 
Exercise is of great use to those threatened with consumption or 
disease of the liver, but hurtful to those with piles, or heart disease. 
Carriage riding is of especial benefit to those in such feeble health, 
or so weak from the effects of a sickness just recovered from, that 
walking or horseback riding is out of the question. Dancing, 
during the midnight hours and in close rooms, far from being a 
healthful exercise, as some pretend, is a fertile source of disease to 
delicate female organizations. Rowing, Swimming and Boxing, 
are useful for the strong, but dangerous, unless great caution be 
taken, for those with weak hearts and lungs. Croquet and quoit 
playing are admirable out-door sports in which invalids may join. 

But our muscles cannot always be in motion ; they are intended 



46 Structure and Action of the Body. 

for interrupted, not continuous action. Rest and sleep are as neces- 
sary as food and exercise. 

A portion of each day must be devoted to repose and recreation, 
as well as to exercise. 

"Xor does Apollo always bend his bow." 

In regard to the amount of sleep required, few can do with less 
than eight hours, and the very young and old need ten or more. 
While there are, doubtless, many sluggards, who relax their bodies 
and dull their minds by too much sleep, most Americans do not 
sleep enough. Time is better gained, for both brain work and hand 
labor, by increasing the attention and energy when awake, than by 
encroaching upon the hours which should be passed in bed. A 
short nap in the afternoon is of great service to invalids and old 
persons. The venerable President Thiers, a remarkably long and 
hard intellectual worker, takes an hour's siesta every day, toward 
evening. 

Deformities. Stooping and relaxed figures, and round 
shoulders, are better remedied by strengthening the muscles of the 
back by judicious exercise, such as we have just recommended, than 
by strapping on shoulder braces. Properly adjusted light steel 
braces, with pads and springs, are, however, of service in cases of 
"spinal irritation'' and curvature. In our work upon female 
hygiene, " The Physical Life of Woman," we have spoken of the 
evil effects of tight lacing, and of improperly constructed braces 
and supports, and need not here dwell upon the subject. 

The application of exercise to medicine as a mode of treatment in 
many diseased conditions, especially for the correction of deformities, 
has of late received much and increasing attention. An enthusi- 
astic Swede, Ling, first erected a building devoted to the art of heal- 
ing by regulated exercise, known as "the movement cure." Such 
institutions are now epiite numerous in Europe. "When we come 
to speak of the various ailments of the body, we shall have occasion 
to mention and describe these movements in their proper places" in 
the treatment of the affections in which they may be usefully em- 
ployed. 



The Different Classes of Bones. 



47 



III. The Bones and Joints. 

The bones are intended to support the soft parts, the flesh of the 
body, to form cavities for the protection of the delicate internal 
organs, and to afford attachment to the various muscles. For these 
purposes they are well fitted by their strength and hardness. 

The analysis of the chemist shows that the bones consist of 
one-third animal matter, as it is called, that is to say of gelatine and 
blood vessels, and two-thirds of earthy matter, that is to say, of the 
phosphate of lime, and other salts of lime, magnesia and soda. The 
proportion of the animal to the earthy materials varies at different 
ages. As we get older, the earthy matter in our bones increases in 
quantity, while the animal matter loses both in quantity and 
quality, hence the bones become more brittle, and as a consequence, 
break oftener. In children, as the animal matter Fi §- 35 - 
is more abundant, the bones are more difficult to 
fracture, and it is frequently seen after an injury to 
a limb, which would have broken it outright in 
more advanced life, that the bone is only bent or 
partially broken, because of the large amount of 
flexible animal matter it contains. Many of the 
diseases to which the bones are liable depend upon 
a change in the proportionate quantities of their 
two constituents. This is observed in "rickets," a 
disease common among the children of scrofulous 
parents, where the bones become bent and curved 
under the weight of the body or the action of the 
muscles. 

Bones are divided according to their shape, into 
four classes: long bones, short bones, flat bones 
and irregular bones. 

The Long Bones are placed, principally, in the 
limbs, where they act as levers, sustain the weight 
of the body, and give us our powers of motion. 
They are hollowed cylinders, the central canal 
being filled up with marrow. Figure 35 shows the 
thigh bone, one of the long bones of the body. The Thigh Bon? 
The Short Bones are strong and compact, and are LongBones! 



4 8 



Structure and Action of the Body. 



placed where only slight and limited motion is wanted, as in the 
wrist. Figure 36 shows the bones of the wrist. The Flat Bones 

Fig. 37. 



Fig. 36. 





Wrist Bones— Example of the 
fchort Bones. 



Shoulder Blade— Example of the 
Flat Bones. 



Fig. 38. 



are thin, broad, flat plates, intended to afford extensive protection to 
the parts beneath, or to provide a wide surface for the attachment 
of muscles The bones of the skull, the breast bone, and the shoulder 
blades, are examples of flat bones, one of which the shoulder blade, 

is shown in figure 37. 

Irregular or Mixed Bones are those 
which, on account of their shape, 
cannot be grouped either under the 
long, short or flat bones. Examples 
are seen in the chain of bones which 
make up the spinal column, the 
vertebrae, as they are called, and in 
the jaw bones. Figure 38 shows, as 
an example of the irregular bones, a 
vertebra. 
™ The body contains two hundred and 

A Verte i^e,uia E r X B a o r n P e , s e ° £ *"* four distinct bones. These are joined 
together, and form what is called the skeleton. The skull is com- 




The Back Bone. 



49 



posed of 8 bones; the face of 14; the ears of 6; the backbone of 
26 ; the chest of 26 ; the upper limbs of 64 ; the lower limbs of 
60. Children have a few more bones than adults, as a number of 
their bones afterward unite to form one. 

These bones grouped together make up the three great divisions 
of the body, the head, the trunk, and the extremities. 

The head includes the skull and face. The skull is a large, bony 
cavity, made up of eight wide, thin and arched bones, immovably 
dovetailed into each other. It contains the brain, and gives passage 
to the spinal marrow through a hole in its lower part, communicat- 
ing with the canal of the backbone. The face is formed of fourteen 
bones, the principal being the upper and lower Fi s- 39 - 

jaws, and of the organs of sight, smell and 
taste. These bones, like those of the skull, are 
of complicated forms and difficult to describe. 

The backbone or spine, is the main support 
of the trunk of the body. It is composed of 
twenty-six distinct bones, called vertebi-ge, 
placed one above the other so as to form a 
pillar or column, on the top of which is the 
head, so joined as to move freely upon it; see 
Figure 39. Seven of these vertebrae belong to 
the neck, twelve to the back, five to the loins, 
and two make the lower end of the column. 
Anatomists give to these the names, derived 
from the Latin, of cervical, dorsal, lumbar and 
sacral vertebrae. They increase in size and 
strength from above downward, so that the 
bones of the loins (the lumbar vertebrae) are 
much larger and stronger than those of the 
neck and back. Those of the back (the dorsal 
vertebrae) have attached to them the ribs, twelve 
in number, on each side, which arch forward 
and are joined to the breast bone by gristle, 
forming the cavity or cage of the chest, to 
contain the heart and lungs, see Figure 40. 
This cavity is separated from that of the belly j. 
5 



50 Structure and Action of the Body. 

Fig. 40. 




Fig. 41. 




Fig. 42. 



The Bones of the Abdo- 
men. 



The Chest Cage. 

or abdomen, which lies below it, by a muscular curtain attached 
to the edge of the lower ribs, called the diaphragm, or midriff. 
The cavity of the belly or abdomen, which 
contains the stomach, liver, spleen, bowels, 
kidneys, etc., is protected in front and at 
the sides by skin, fat and muscles only, 
and has no bony walls excepting below 
and behind. Its floor is made up of 
four bones attached to the lower end of 
the back, and spread out so as to form 
a sort of basin, called by anatomists, the 
pelvis, see Figure 41. 

Having thus passed in review the bony 
framework of the head and of the trunk 
of the body, it only remains for us to 
say a few words on the extremities or 
limbs, see Figure 42. The upper ex- 
tremity is composed of the shoulder, 
which has two bones, the collar bone and 
the shoulder blade, connecting it with the 




The Different Kinds of Joints. 5 1 

trunk; of the arm, which has only one bone, extending from the 
shoulder-joint to the elbow; of the forearm, which has two bones, 
extending side by side from the elbow to the wrist ; of the wrist, 
which has eight short bones; and of the hand, which has four 
bones in each of the four fingers, and three in the thumb. The 
ends of these bones, where they are joined together, are smooth 
and polished, so as to move freely and easily upon each other. 

The lower extremity is composed of the thigh bone, the 
largest and strongest bone in the body, which extends from the hip 
joint to the knee; of the knee-pan, placed in the sinew of the large 
muscle lying in front of the knee joint; of the two bones of the leg, 
extending side by side from the knee to the ankle; of the ankle 
which has seven small bones, one pointing out behind to form the 
heel ; and of the foot, which has the same number of bones as the 
fingers and thumb, but shorter, and incapable of moving so freely 
upon each other. 

All of these two hundred and four bones which compose the 
head, trunk and extremities, constituting " the skeleton," are con- 
nected together by means of joints. Some of these joints, like 
those uniting the bones of the skull, are immovable, but most of 
the others are movable joints. The movable joints are surrounded 
by strong, flexible bands, called ligaments, which keep the ends of 
the bones together in place, while permitting of perfect freedom of 
movement. When, by severely applied force, the ends of the 
bones, in spite of the resistance of the bands surrounding them, are 
thrown out of place, the joint is said to be dislocated. The treat- 
ment of dislocations will occupy us in the part of this volume 
devoted to accidents and injuries. 

There are four kinds of movable joints: The Gliding Joint, in 
which the surfaces of the bones glide upon each other, as is seen in 
the joint between the breast and the collar bones. The Ball and 
Socket Joint, in which a round head is received into a cup-like 
cavity, permitting of motion in every direction, as is seen in the 
hip and shoulder joints. The Hinge Joint, in which the only 
motion is backward and forward, as is seen in the elbow and knee. 
The Pivot Joint, in which a pin-like process turns within a ring, as 
is seen in the attachment of the head to the spinal column. 



52 Structure and Action of the Body. 

Various deformities in the position and shape of the hones are 
met with. The defect frequently spoken of as the "growing out 
of the shoulder blades," is one of the penalties of tight lacing, in 
girlhood. It also occurs in feeble children growing too rapidly, 
and then calls for nourishing food and healthful exercise. Constant 
confinement, writing or painting, with one ann elevated and the 
other at rest, gives the shoulders a "one-sided" appearance, and the 
habit of leaning forward imparts to the chest a "dished" appear- 
ance, particularly displeasing in women. "Chicken-breasted" or 
narrow-breasted children require especial attention to their health, 
little study, and vigorous out-door country life, to escape the fatal 
disease of the lungs with which they are threatened. " Club-foot" 
is usually, found at birth, but may be developed afterward by fits, 
spasms, or a vicious habit of walking, owing to the presence of a 
corn, or sore, which causes the person to tread on one side of the 
foot, and so distort the bones. It may affect one or both feet, and 
should always receive prompt attention from the surgeon, when a 
perfect cure may be confidently expected. The longer the necessary 
surgical treatment is deferred the more difficult and the more unsat- 
isfactory the operation becomes. Parents who allow children to 
grow up with this deformity, now so readily remediable, are guilty 
of a great wrong. The usual cause of " bandy legs " or " bow-legs," 
is allowing children to walk too soon, at a time when there is too 
little of that earthy matter, of which we have been speaking, 
in the bones of the legs, in proportion to the animal matter, to 
support the weight of the body without bending. Once bent in 
this way they cannot be straightened. 

The Teeth. Though bom toothless, we are afterward burnished 
with two sets of teeth, which appear at different periods of life. 
The first set, called temporary, milk, or baby teeth, present them- 
selves in infancy. They are twenty in number, four front, two 
canine, and four grinders in each jaw. The second set, called 
permanent teeth, also appear early in life. They are thirty-two in 
number. In each jaw there are four front or cutting teeth ( termed 
also incisors), to divide the food ; two canine (the upper are also called 
eye teeth), to pierce the food ; four small or false grinders (named also 
bicuspids), and six grinders or molars, to grind the food. The last 



The Teeth. 



53 



arrivals, the third grinders, or those furthest back in each jaw, have 
received the name of wisdom teeth, from their late appearance 
through the gum. Occasionally a third set of teeth re-garnish the 
mouth in very advanced life, which are as solid and serviceable as 
their predecessors. 

A few words upon the structure of the teeth. Each tooth has 
three parts: the crown or body, which projects above the gum; the 
root or fang, by which it is attached to the jaw; and the neck, 
which is the narrowed part just below the crown. 

Fig. 43. 




The Permanent Teeth. 
Figure 43 shows the shape of each of these different teeth, in 
the order in which they occur, on one side of each jaw. On cutting- 
through a tooth a cavity will be found to exist inside, occupying the 
center of the crown, and running down into each root, to a very 
small opening at its extremity. This cavity 
contains the pulp of the tooth, and is furnished 
with blood vessels and nerves through the small 
openings at the ends of the roots. This is shown 
in Figure 44. The solid part of the tooth is 
composed of three different substances : the ivory, 
or tooth bone (called also the derrtine) ; the enamel, 
which covers the crown; and the cement, which 
covers the root and sets it in its socket. The 
enamel, the hard and white glittering armor of the tooth, should be 
carefully cared for, as upon its preservation depends that of the 
5* 




The Inside of 
a Grinder. 



54 Structure and Action of the Body. 

whole tooth. If chipped off, or eaten through by decay, the tooth soon 
rots and aches. Being mainly composed of lime, it is readily corroded 
or softened by anything that is sour. The constant use of acid 
fruits or fluids, as also of very hot or very cold foods or drinks, unless 
great caution be exercised, is injurious. But, by far the greatest 
source of injury, lies in the fermentation of particles of food indo- 
lently left between the teeth. For this reason, the habit should be 
formed of rinsing the mouth and picking the teeth (but only 
with a quill, ivory, tortoise shell or gold pick), after each meal. 
The enamel is sometimes observed to change in color with the state 
of the health. Thus, in bilious people it turns yellow, and in 
consumptive people it occasionally becomes of an unnatural pearly 
whiteness. Receipts for the care of the enamel, by tooth powders 
'and mouth washes, we give later on in their place in the work ; for 
the page consult the index. 

The teeth of the upper jaw, in consequence of its having a larger 
curve than the lower, overlap the teeth of the lower jaw. Thus 
the edges of the cutting teeth do not blunt each other, as they would 
if they met. 

The periods for the appearance of the first set (the temporary, 
milk, or baby teeth) are as follows : — 

Seventh month, the middle front. 

Seventh to tenth month, the side front. 

Twelfth to fourteenth month, the front grinders. 

Fourteenth to twentieth month, the canine. 

Eighteenth to thirty-sixth month, the back grinders. 

The second set (the permanent teeth) appear at the following 
periods, those of the lower jaw showing themselves a short time 
before those of the upper: — 

Six and a half years, the first grinders. 

Seventh year, the two middle front. 

Eighth year, the two side front. 

Ninth year, the first false grinders, or double teeth. 

Tenth year, the back false grinders, or double teeth. 

Eleventh to twelfth year, the canine. 

Twelfth to thirteenth year, the second grinders. 

Seventeenth to twenty-first year, the wisdom teeth. 



The Teeth. 55 

Hygiene of the Teeth. When, there is a hereditary tendency 
to decay of the teeth, especial care should be taken to keep the 
spaces between them clean and bright. Sometimes, particularly in 
the case of young girls, the tops of the gums, which become spongy 
or swollen, hang down between the teeth, and so conceal decay 
until serious mischief has been done. The teeth should be brushed 
with a soft brush, every morning and evening, and a toothpick 
used, and the mouth rinsed out with tepid water after every meal, 
to prevent the accumulation of particles of food between the teeth. 
The enamel of the teeth is quickly attacked by the acids generated 
by the decomposition of fragments of food suffered to find a lodging 
place between the teeth. 

To keep the teeth clean, and prevent the deposit of tartar, it is 
not sufficient to brush their fronts. The backs of the teeth, par- 
ticularly those of the front teeth of the lower jaw, require attention. 
A useful brush is especially made for this purpose, and sold by 
most druggists. 

A tooth-sponge is often preferable to a tooth-brush, which, if it 
be hard, hurts the gums and wears the enamel. It is made by 
attaching a piece of fine sponge, about the size of a walnut, to a 
handle, and furnishes a very pleasant substitute for a brush when 
the gums are tender. The sponge enters the inequalities of the 
teeth more readily than bristles, does not uncover the necks of the 
teeth by rubbing away the gums, as sometimes happens from inju- 
dicious friction with a brush, and can be easily kept clean. 

When, in consequence of advancing years, or of neglect of hygiene, 
the teeth decay and drop out, their place should be supplied by 
artificial ones, the making of which has now become such an art, 
and one in which American dentists have acquired so much celeb- 
rity. Much of the dyspepsia of old age is to be attributed to the 
inability to properly chew the food and mis it with the saliva. 
In such cases, the dentist is the best doctor, and a set of artificial 
teeth the best stomachic. Attention to this suggestion will, in 
many instances, remove prolonged ill health, of which the true 
cause has not been suspected. 



m 




CHAPTER II. 

THE INSTRUMENTS OF THE BODY AND THEIR OFFICES. 

Section I.— The Air Passages and Organs.— The Lungs— Their struc- 
ture and use— What happens to the breathed air in the air tubes and 
cells— On ventilation — Simple ways of changing the air in a room without 
draughts. 

Section II.— The Food Passages and Organs.— The manner in which 
food reaches the stomach— The process of digestion— The structure of 
the stomach and Dowels— Classification of food— Practical directions for 
the corpulent for reducing flesh— How to become stouter— Appetite and 
hunger. 

Section III.— The Blood Passages and Organs.— The structure and 
action of the heart— The course of the blood— The capillary vessels, 
what they are and how they act— The arteries and veins— The changes 
taking place in the blood, in the lungs, and in the network of small ves- 
sels—The office of the blood— How at the 6ame time it nourishes and 
purifies the body. 

Section IV.— The Waste Passages and Oegans.— The action of the 
lungs, the skin, and the kidneys, in removing the products of waste and 
decay. 

Section V.— The Speciae Senses.— The five gateways of knowledge— 
Of Smelling— How effected— The nose a respirator — Uses of the sense of 
smell — Its duties as a sentinel— Of Tasting — The manner in which the 
impression of taste is produced — The importance of pleasing the palate 
of the sick— Of Touch— The feelers of the skin— Of Hearing— The struc- 
ture of the ear — How sound reaches the brain — Hints on the hygiene of 
the ear— Of Seeing— The structure of the eye— The offices of its different 
parts — A ray of light on its journey to the retina — Defects of the eye, 
their cause and prevention — Short sight— Long sight — Old sight. 

{action VI.— The Brain and Nerves.— The structure of the brain- 
Its office — The distribution of the nerves — Their office. 

Hitherto we have been occupied with the framework of the 

body, its coverings and its motions. But the skin, the muscles and 

the bones, are not the most important parts of our bodies. Within 

this framework are certain instruments or organs, which perform the 

56 



The Instruments of the Body and their Offices. 57 

various offices which keep us in life. In order to live we must 
breathe and eat, our blood must circulate, and the waste products 
of our bodies must be thrown out of the system ; for these pur- 
poses we are furnished with air, food, blood, and waste passages and 
organs. In order to enjoy life, provide ourselves with food, and 
protect ourselves against injury, we are furnished with special 
senses, five in number, sight, hearing, smell, taste and touch. We 
shall, therefore, complete our study of the structure and action of 
the body, by a consideration of these various passages and organs, 
and of the senses, which are their servants and guards. 

I. The Air Passages and Organs. 

The air enters the cavities or sacs of our bodies called lungs, by 
means of the windpipe or air tube, which is divided into two 
bronchial tubes, which go on breaking in twos and twos, until the tubes 

Fig. 45. 

W 




The Lungs, 
are hardly larger than thick pins. Each of these ultimate delicate 
tubes end in a little cell or pit, called the "pulmonary cell" or 
"vesicle," which is only T V of an inch in diameter. This distribu- 
tion of the windpipe and its branches is well shown in Figure 45. 



58 Structure and Action of the Body. 

W is the windpipe, dividing into the right and left bronchial tubes, 
3, which go on subdividing. B indicates the blood vessels which 
accompany the bronchial tubes; 1, being the pulmonary artery, 
conveying blood to the lungs; '1, the pulmonary veins, returning it 
back to the heart. Of the use of these arteries and veins we shall 
have to speak directly, when we come to the blood passages. The 
space around the air cells is filled with spongy structure, and the 
lungs themselves are covered or clothed with a smooth membrane, 
called the pleura. It is the inflammation of these air cells and of 
the spongy structure about them, which makes the disease known 
as lung fever, or pneumonia; inflammation of the membrane 
covering the lungs is what is known as pleurisy; inflammation of 
the lining membrane of the ah- tubes constitutes bronchitis. These 
diseases and their treatment will be discussed in the second part of 
this work, devoted to the ailments of the body. 

The air, entering by the mouth and nostrils, is conveyed, by 
the windpipe and its numerous branches, to the minute lung-cells, 
where it comes in contact with a thin layer of blood spread out 
around the walls of each cell in tiny blood-vessels. An important 
change there takes place in the blood thus exposed to the action of 
the air, which we shall explain shortly. 

The lungs are filled with air by the expansion of the chest, 
effected by the muscles around the ribs, and by the large muscular 
curtain, the diaphragm, already described, separating the chest from 
the abdomen. The action of these muscles, though to a limited 
extent under the control of our will, goes on as previously mentioned, 
without our knowledge or assent. Death ensues from stopping the 
motion of the chest, as nearly happened in the case of a negro, 
whose fine bust induced some artists to take* a mould of it. As 
the plaster in which he was encased set, he could neither cry out 
nor breathe, and would have perished, if one who knew the actions 
of the body had not come in and dashed to pieces the cast. With 
each movement of respiration, we take in and discharge from the 
lungs about twenty cubic inches, or nearly half a pint, of air. As 
we breathe about eighteen times a minute, we inspire about three 
hundred and sixty cubic inches of air a minute, fourteen cubic feet 
an hour, or nearly three hundred and fifty cubic feet daily. 



The Lungs and Their Work. 59 

What happens to the air thus breathed? Most of our readers 
know that the atmospheric air is almost entirely a mixture of two 
gases, oxygen and nitrogen, in the proportion of about one-fifth 
oxygen to four-fifths nitrogen. It also contains a very small quan- 
tity of carbonic acid gas, about one part in two thousand, a varying 
amount of watery vapor, and some traces of ammonia. But these 
ingredients are altogether insignificant beside the oxygen and nitro- 
gen which constitute its great mass. After expulsion from the 
lungs, the air is found, when collected and examined, to have 
undergone the following important changes : it has lost oxygen, it 
has gained carbonic acid, and it has absorbed the vapor of water. 
It has also become somewhat warmer. But by far the most import- 
ant change which has taken place in the breathed air, is its loss of 
oxygen and its absorption of carbonic acid. The lost oxygen has 
gone to, and the gained carbonic acid has come from, the blood, 
passing through the thin covering of the blood-vessels spread in a 
fine network about the air-cells of the lungs. This supply of oxygen 
to the blood, and the escape of carbonic acid from it, is necessary to 
life ; if it be interrupted only for a few minutes, death follows. 

The carbonic acid thus thrown out contaminates the air about 
us, and unfits it for rebreathing. The quantity exhaled from the 
lungs varies with the sex, the age, and the constitution. Men 
produce a larger quantity than women, usually nearly twice as much 
between the ages of sixteen and forty. The quantity increases in 
the male from eight to thirty years of age, and then begins to 
decrease, so that near the close of life the quantity may be no 
greater than at ten years of age. With women, on the contrary, 
the quantity increases from eight years of age until about the four- 
teenth year is reached, and then remains stationary until about the 
age of forty, when it decreases, as in men, towards old age. The 
stronger the constitution and the more developed the muscles, the 
greater the quantity of carbonic acid given off from the lungs in 
both sexes. The quantity is increased during digestion and active 
exercise ; lessened by sleep, repose, fatigue, and whatever interferes 
with perfect health. 

The process of breathing is not strictly limited to the lungs, but 
this exchange of oxygen from the air for carbonic acid from the blood, 



6o 



Structure and Action of the Body. 



takes place, to a certain extent, through the skin, as mentioned in the 
chapter on the external coverings of the body. That this exchange 
of gases actually takes place through the skin, has been ingeniously 
proved by enclosing one of the limbs in an air-tight case, when it 
was found that the confined air lost oxygen and gained carbonic 
acid. It is supposed that from the whole surface of the human body 
a quantity of carbonic acid escapes equal to abuut one-sixtieth to one- 
thirtieth of that given off, during the same period, from the lungs. 
We now understand why rebreathed air and close rooms are 
poisonous, and see the necessity of 
ventilation, the object of which is to 
furnish us with a constant supply of 
pure air for breathing. 

Ventilation. Air, to be fit for 
breathing, should be changed at the 
rate of about two thousand cubic feet 
an hour for each person. In constructs 
ing houses, every room should be fur- 
nished with ventilators, on the system 
of " base ventilation," which permits of 
the escape of the vitiated air, not from 
the top of the room, but from openings 
near the floor. The open fire-place 
acts upon this principle, and, as is well 
known, is one of the best of ventilators. 
The windows are the only means for 
ventilation provided in most houses; 
and as these are closed in stormy 
weather, and occasion direct drafts 
when open, they answer the purpose 
very imperfectly. A number of inge- 
nious window-sash ventilators have 
been lately invented and patented, 
which are permanently fitted to the 
sash, and supply fresh air in small 
Window sash Ventilator. curre nts, without any direct draft, while 
the window itself is closed and securely fastened. A simple, effective, 



I 

f. 

j 


— T— 








i 




! - if'l 1 






: 






h ^r~T 







How to Make a Ventilator of a Window. 61 

and "non-patented" window ventilator may be readily made out of a 
piece of board the exact breadth of the lower sash. This board is 
placed under the lower sash, which is thus raised a few inches, and 
its upper edge elevated above the lower edge of the upper sash, so 
that a current of air passes through the opening so formed, without 
causing any direct draft. Figure 46 gives a very clear idea of this 
simple method of ventilation. A represents the piece of wood, an 
inch or more in thickness, three inches wide, and the length of the 
breadth of the window. If this slip be well fitted, no draft will 
occur between it and the sill, or the frame of the sash. D shows 
the separation between the lower edge of the upper sash and the 
upper edge of the lower ; and the arrows the perpendicular currents 
of air passing in and out of the room, without any inconvenience 
from draft or exposure to rain. 

II. The Food Passages and Organs. 

The body is a working machine, and, like all other machines, 
wears away in use. Our bones and muscles, so firm and strong, 
need constant repair to keep them so. For tbis purpose, food is 
necessary, and a series of instruments or organs by which it may be 
changed within us into flesh and bone. We are, therefore, furnished 
with teeth to chew, palates to taste, throats to swallow, stomachs to 
digest, and bowels to carry off refuse matter. 

Food, in the first place, is taken into the mouth. It is there 
mixed with saliva, and cut and ground into a sort of paste by the 
jaws and teeth. The lower jaw moves in every way, so that we 
chop like a dog and grind like a cow. This operation is a very 
necessary one, and should never be hastily performed. If the food 
be bolted in undivided masses, it lies for a long time in the stomach, 
which it irritates and disturbs, while, if well chewed, it is readily 
attacked by the juices of the stomach and quickly digested. The 
chewed mass, when swallowed, enters a long muscular canal, the 
gullet, which passes through the chest, behind the heart and lungs, 
and is thus conveyed to the stomach. The stomach is an irregularly 
shaped muscular bag or sac, curved upon itself, lying in the upper 
part of the abdomen, at the spot commonly named the " pit of the 
6 



62 Structure and Action of the Body. 

stomach." It is the principal organ of digestion, measuring in the 
average, when moderately full, about twelve inches across and about 
four inches up and down, and containing easily a quart of water. It 
is capable, however, of great extension or contraction, according to 
the amount put into it. There are two openings; one at its highest 
part, communicating with the gullet, the other a lower one, on its 
right side, communicating with the small bowels. The food here 
comes in contact with a peculiar fluid, called the gastric juice, with 
which it is thoroughly intermixed by the movements of the stomach, 
which rock, as it were, the food to and fro. The gastric juice is 
nearly tasteless, colorless, and odorless, but acts in a most powerful 
manner upon the substances exposed to its influence, converting 
them into a grayish mass, like thick cream, called chyme. The 
process of digesting or dissolving the food in the stomach being 
thus completed, a portion of it is slowly taken up by the veins, and 
the rest passes out through the lower opening into the small or first 
bowel. Liquids taken into the stomach are, for the most part, 
sucked up by the blood-vessels in its walls, and do not enter the 
small bowel. The solid food, thus converted into chyme, is now 
subjected, in the small bowel, to the action of the bile and the pan- 
creatic juice. The bile is a very bitter fluid, prepared by the liver, 
a large organ placed in the right side of the abdomen, just beneath 
the ribs. The bile is collected in the gall bladder, where it is re- 
served for use. The pancreatic juice, which looks very much like 
the saliva, is prepared by the pancreas, an organ lying just below 
the stomach. Neither sugar, starchy nor oily or fatty matters are 
dissolved in the stomach, but in the small intestine, by the action 
of these two fluids, which also secure the proper digestion of other 
parts of the food that may have escaped the'stomach. When the 
chyme comes in contact with these two fluids, it is separated into 
two parts, the one a thin, whitish, milk-like liquid, called chyle; the 
other is the portion of the food unfit for nourishment, which is re- 
jected and thrown out of the bowels as useless. The chyle is sucked 
up by an army of minute vessels, which have their mouths in the 
walls of the small bowel. It is emptied by these numerous vessels 
into a long tube, about the size of a goose-quill, called the thoracic 
duct. This duct, eighteen to twenty inches in length in the adult, 



The Food Passages and Organs. 63 

ascends the abdomen along the back, resting against the spine, and 
pours its contents, under the left collar bone, into the vein coming 
from the left arm, where they mingle with the blood, and so the 
food finally enters the circulation, becomes a part of the blood, and 
is carried throughout the body by the heart, arteries and veins. 

The colored frontispiece of this book shows in a beautiful manner 
these food passages and organs, in a way which makes them clear to 
every one. On lifting the leaf an inside view of the cavities of the 
chest and abdomen is obtained. We see the little white vessels carry- 
ing the chyle, coming from all points, grouping themselves into knots, 
and finally uniting to constitute the reservoir of the thoracic duct, 
vp, from which the duct, c t, starts, which ascends, resting against 
the spinal column, passing behind the blood vessels of the neck, and 
opening into the vein coming from the left arm, v sg. Over this 
picture of the open trunk is seen one of the digestive canal, from 
the mouth to the lower bowels, namely, the mouth, b; the gullet, 
as; the stomach, e; the opening from the stomach to the small 
bowel, py; the liver,/; the small bowel, Hi; the pouch which 
begins the large bowel, cce; the transverse portion of the large 
bowel, c t, and the descending portion of the large bowel, c d. 

The small bowel is that part of the digestive canal where the food 
already acted upon by the stomach and converted into what is called 
chyme, as already explained, is mixed with the bile, the pancreatic 
juice, and the products of various glands imbedded in the walls of 
the bowel, and where the separation of the nutritive principle of the 
food, called chyle, is eifected, as we have just shown. It is a curved 
or rolled up tube, twenty feet long, with folds to prevent the contents 
from passing along too rapidly, with little pits and gland-cells, which 
pour out fluid, and with minute processes projecting from its walls, 
through which the small white vessels, called lacteals, suck up the 
chyle, to carry it to the reservoir, in the manner just pointed out. The 
small bowel is designated by the letters Hi in the colored frontispiece. 

The large bowel is about five feet long, and passes from the right 
haunch, where it has valves to prevent its contents from returning 
into the small bowel, to below the left haunch. The muscles in the 
walls of the bowels, which, as was pointed out in speaking of the 
muscular system, in the first chapter, belong to the class of involun- 



64 Structure and Action of the Body. 

tary muscles, give worm-like movements to the bowels, which propel 
their contents and expel them when all that is useful to the blood 
has been extracted. 

Food may be divided into those articles that warm us, as fat, starch 
and sugar, and those that form us, as the flesh of animals. The 
heat-foods are also fattening foods. Hence the corpulent should be 
chary in the consumption of fats and vegetables, which contain 
starch and sugar in large quantities ; on the contrary, those who are 
too lean ^hould partake freely of these substances. The articles 
which the corpulent should specially he frugal in the use of are; 
bread, butter, milk, sugar, sweet and white potatoes, molasses, fat 
meat, Indian corn, pastry, beer. The more nearly these articles are 
excluded altogether from the table, the more rapid will be the reduc- 
tion of weight. At the same time, as little fluids of all kinds should 
be drank as is consistent with comfort. To decrease in size, the diet, 
therefore, should consist principally of animal food. To increase in 
size, a diet largely vegetable is required: among the vegetables, the 
roots are ordinarily particularly fattening, while those which ripen 
above ground are less so. The articles which spare persons should 
avoid if they desire to become stouter are: pickles, vinegars, highly 
spiced food, sour wines or fruits, acid vegetables. Those who think 
themselves too fat or too thin, should frequently weigh themselves, 
so as to learn what articles of food are, in their individual cases, 
the most fattening. Thus some have found in their own persons 
that sugar is that which most rapidly heaps up fat; others find 
fresh milk the most fattening; while with not a few, starch, in the 
form of arrowroot, sago, tapioca, or farina, is the most rapidly 
converted into fat. 

The above remarks contain, in a few words, the secret of 
Bantingism, the doctrines of Mr. Banting, that pursy Englishman 
whose writings on corpulence have lately attracted so much attention. 

The foods which principally furnish us with heat and fat, have 
also nearly all the business of supplying us with force to work the 
machinery of the body. The body may be aptly compared to the 
steam engine, and food to its fuel. The masses of iron, steel and 
brass which make up the engine, are as useless without the fuel to 
create heat, and thus force and motion, as would be the bones, 



Appetite and Hunger. 65 

muscles, sinews, blood vessels and nerves, which make up our body, 
without the food to give birth to heat and force within us. But 
the steam engine differs from the human body, in the fact that its 
parts, when they wear out, can be removed and renewed. No such 
rough method of repair is possible in the case of the body, which is 
a machine constantly working, constantly wasting, and constantly 
repairing its own wear and tear. Food is, therefore, more to us 
than fuel is to the steam engine ; as it has the threefold office of 
supplying us with heat, with the means of motion, and with the 
elements of repair. Hence it must consist of more than one kind 
of material. If we regard bread and meat as the staple of life, we 
find all that is necessary for the threefold mission of giving heat, 
force and substance. The bread is composed chiefly of starch, 
which may be compared to the coal of the steam engine ; the meat 
is composed of two parts, the fat and the lean, of which the former aids 
the stareh in propelling the machine, and the latter repairs the waste. 
A few hours' want of food causes, in a healthy person, appetite ; 
longer abstinence, gives rise to hunger. The symptoms of starva- 
tion, faintness, coldness, shrinking of the body, and wandering of 
the mind, result, if no food be had for a day or two. Death ensues, 
usually, at the end of about a week's total deprivation of food and 
water, that is to say, when the body has consumed about two-fifths of 
itself, for when a person has nothing to eat he lives upon himself. 
But if water be taken, a case upon record shows that life may be 
prolonged, entirely without solid food, during thirteen days. Thirst is 
more quickly fatal than hunger, because of the thickening of the 
blood which rapidly takes place. An urgent feeling of hunger is 
not a prominent symptom in cases of gradual starvation ; if it exist 
at first it soon disappears, and is followed by a feeling of exhaustion, 
faintness, and even loathing of food, and death is ushered in by 
listlessness and torpor. Thus we find in this, as in other modes by 
which death may approach, 

" Many are the ways that lead 
To his grim cave, all dismal ; yet to sense 
More terrible at the entrance than within." 

The proper treatment of starvation will occupy us when we come 
to speak of the ailments of the body. It is an important subject, 
6* 



66 Structure and Action of the Body. 

as not only sailors and travelers, but also the poor waifs of our streets 
(for people yet die of quick as well as slow starvation in our large 
cities), have, when rescued, lost their lives through the ill-advised 
efforts of their zealous but ignorant benefactors. 

III. The Blood Passages and Organs. 

The blood in our bodies is in constant motion. This motion is 
called the circulation, and takes place through the heart, arteries 
and veins. The mainspring of the circulation is the hollow muscle 
called the heart ; the pipes or canals which carry the blood from the 

Fig. 47. 




Inside of the Heart, 
heart to the different parts of the body are called the arteries, and 
those which bring it back to the heart after it has made its course 
are called the veins. 

The heart, in size somewhat larger than the fist, is double, con- 
sisting of two parts, each forming a complete and distinct organ. 
They are separated from each other internally, though their walls are 
united externally, and are known under the names of the right and 



The Blood Passages and Organs. 67 

left sides of the heart ; one, the right, pumping the blood to the lungs ; 
the other pumping it through the body. They are each subdivided 
into two rooms or cavities, holding about a wineglassful of blood, 
the upper, called the auricle, the lower, called the ventricle. This" 
is well shown in Figure 47, representing the heart cut through, with 
each half turned back, so as to display the structure of the two sides, 
which, it must not be forgotten, do not communicate directly the 
one with the other. 

The right side of tlje heart has its own work to do, very different 
from that performed by the left side. It is the province of the right 
side to receive the blood from all parts of the body, brought to it by 
two veins, which open into the right auricle, ra, whence it passes 
into the right ventricle rv, and to send it to the lungs through the 
large vessel, shown in the figure, called the pulmonary artery. It is 
the province of the left side of the heart, on the contrary, to receive 
the blood from the lungs, brought to it by four veins, called the 
pulmonary veins, which open into the left auricle, la, whence it passes 
into the left ventricle, Iv, and to send it to the body through the large 
artery, shown in the figure, called the aorta. The direction of the 
arrows indicate the course of the blood. Thus, it will be seen, there is 
a double circulation as well as a double heart ; one round of circulation 
from the lower chamber of the right side of the heart (the right 
ventricle), through the lungs, to the upper chamber of the left side 
of the heart (the left auricle) ; the other round of circulation from 
the lower chamber of the left side of the heart (the left ventricle), 
through the body, to the upper chamber of the right side of the 
heart (the right auricle). 

The rapidity with which the blood circulates through the body 
varies at different hours of the day, being the greatest when the 
necessity is the most urgent. After a meal, for instance, the heart's 
action is increased, rising a number of beats per minute, for one and 
a half to two hours, or more, after which it lessens until the next 
meal, when it again rises and falls. The pulsation of the heart 
is the slowest and the most feeble during the night, between two 
and five in the winter, and between one and three in the summer. 
At these hours, therefore, many persons who are very ill die, and 
the sick require the most careful watching. 



68 Structure and Action of the Body. 

Figure 48 shows a scheme or plan of the circulation. The 
uppermost circuit is that of the head, neck, and arms, the middle 
that of the lungs, and the lower that of the trunk and lower limbs. 
Fi g- 48 - The lines on the right side of 

the figure (the left side of the 
heart) indicate arteries, by which 
the blood is conveyed from the 
heart ; the lines on the left side of 
the figure (the right side of the 
heart) indicate the veins, by which 
the blood is returned to the heart. 
The course of the blood through 
the heart is, therefore, as follows : 
From the two great veins, one 
from the upper, and the other 
from the lower part of the body, it 
passes into the right auricle, ra, 
Figure 47, and from the right 
auricle into the right ventricle, rv. 
This right ventricle contracts forci- 
bly, driving the blood through the 
pulmonary artery to the lungs, it 
being prevented from returning 
into the right auricle by the clos- 
ing of the little doors or valves 
which guard the opening. Re- 
turning from the lungs, it enters, 
by the four pulmonary veins, the 
left auricle, la, thence passes into 
the left ventricle, Iv, from which it 

is driven with great force into the 
Plan of the Circulation of the ^ ^^ thg aorta) whi(jh ^ 

tributes it, by means of its ramifications, throughout the body. 
The passage ways from the auricles to the ventricles, as well as the 
mouth of the pulmonary artery, which leads to the lungs, and that 
of the main artery, the aorta, which leads to the general system, 
are furnished with doors or valves, which prevent the blood from 




The Circulation of the Blood. 



69 



Fig. 49. 



going out of its right course. These valves are often put out of 
order by rheumatism, an ailment which is, therefore, especially to 
he dreaded, because of the permanent heart disease which some- 
times follows it. 

The arteries end and the veins begin, that is to say, they are 
connected together, by an infinite number of small vessels, called 
capillaries, so named because they are as fine as a hair. These 
capillaries are of different sizes, and branch in various directions all 
over the body, being woven into every part, and it is by them that 
the blood is brought into intimate contact with the substance of the 
tissues, and spends itself as it passes through them, on its way from the 
arteries to the veins, to be returned to the heart for another round. 

Figure 49 shows the manner in 
which these capillaries are inter- 
laced in the web of a frog, which 
being transparent, displays beauti- 
fully, under the microscope, the 
passage of the blood in these 
minute vessels, which, on account 
of their fineness, admit only a 
single blood cell at a time. The 
cells which crowd the blood rush in 
from the artery, pass, one at a time, Magnified Capillary Vessels, 
slowly along these capillaries, lingering to nourish .the tissues and 
take up their waste, and then hurry away by the vein. Or, as Dr. 
Holmes poetically expresses it, 




"Far and wide a crimson jet 
Leaps forth to fill the woven net, 
Which in unnumber'd crossing tides 
The flood of burning life divides, 
Then, kindling each decaying part, 
Creeps back to find the throbbing heart. 1 



The action of the heart and the course of the blood, constituting 
what is known as "the circulation," was discovered and first 
described by Dr. Harvey, an eminent English physician, in 1619. 
Twenty years previous to this, however, the great poet of nature, 



jo Structure and Action of the Body. 

Shakspeare, indicated the way the blood goes in fainting, and what, 
in that condition, should be guarded against, as follows: — 

" Why does my blood thus muster to my heart, 
Making both it unable for itself 
And dispossessing all my other parts 
Of necessary fitness ? 

So play the foolish throngs with one who swoons; 
Come all to help him, and so stop the air 
By which he should revive." 

The blood does not flow through the heart steadily and continu- 
ously, but is impelled through by alternate contractions and 
relaxations of the muscular walls ; at each squeezing together of the 
sides, a successive portion of blood is received by the auricles, 
delivered into the ventricles, and by them discharged into the 
arteries. Each of these actions is called a beat or pulsation of the 
heart, and as they occur every second, there are, during an ordinary 
life, three thousand millions of beats, without a break. 

The Arteries and Veins. We have spoken of the heart as 
the organ into which the veins open, and from which the arteries 
arise, and of the capillaries, as the minute vessels interwoven 
throughout the tissues, in which the arteries end, and from which 
the veins begin. It now remains for us to .say a few words in regard 
to these arteries and veins themselves. The main artery is the 
aorta, which, as already mentioned, is given off from the lower 
chamber of the left side of the heart (the left ventricle). In man it 
is about an inch in bore, but in the whale it is over a yard in 
diameter. It furnishes branches for the head and arms, curves to the 
back of the chest, supplies the organs in the trunk, and ends at the 
loins in two branches, for the haunches and legs. These various 
branches go on dividing and subdividing into smaller and smaller ves- 
sels, which finally end in the capillaries. Tbe veins which begin at 
the capillaries run into each other, uniting, so as to form fewer and 
fewer, and larger and larger vessels, until finally they make but two, 
one from the upper, and the other from the lower part of the body, 
which pour their contents into the upper chamber of the right .side 
of the heart (the right auricle). The knots in the veins, which 
may be distinctly seen in those on the back of the hand, are made 



The Blood and its Offices. 71 

by the little valves inside, which open toward the heart so as to 
permit of the passage of the blood in that direction, and prevent it 
from going in the other. 

The Blood. When the blood has passed through the system, 
and arrives at the right side of the heart, it is of a dark bluish red 
or purple color, approaching almost to black. Because of its color, 
it is commonly called black blood. It is unfit for circulation in the 
vessels, or for accomplishing its great work, the nourishment of the 
different parts of the body. In this condition it is sent to the 
lungs. When speaking of the air passages and organs, we described 
the lungs as made up of a collection of air tubes, terminating in 
air cells, surrounded by blood vessels, and explained the manner in 
which the air was drawn through the windpipe, and distributed to 
every part of the lungs, and thus brought in contact with the blood 
contained in the thinly-coated blood vessels running around the 
air-cells. We also mentioned that the air, while in the lungs, lost 
some of its oxygen, and received carbonic acid. The dark, venous 
blood, unfit for circulation and nourishment, is sent to the lungs 
from the right side of the heart, in order to receive oxygen from 
the air, and to give off carbonic acid. There, it changes color, and 
becomes of a bright crimson or vermillion hue. Then, being fitted 
for the purposes of life, it is brought to the left side of the heart, to 
be distributed (through the ramifications of the great artery, the aorta, 
which, as we have seen, supplies the whole body with blood) to the 
network of capillary, or hair-like, vessels, spread out in the substance 
of all the structures and tissues of the body. Here, in this system 
of capillary vessels, while going to the veins, it undergoes a change 
exactly opposite to that it experienced in the lungs. It loses its 
bright red color and becomes of a dark purple hue. This change 
is in consequence of the office which the blood performs in the 
nutrition of the body, in parting with some of its constituents, 
which combine with the texture of the flesh, tissues and bones, in 
order to supply waste and maintain life. 

But this is not the only office of the blood, important as it is — to 
serve as a kind of fluid flesh, and bone, and brain, and to bring, 
during a year, as it is calculated to do, over a ton of material from 
the food, for the building of our bodies. It is also the great drain, 



72 Structure and Action of the Body. 

which carries to the lungs, skin and kidneys, to be cast out of the 
system, the broken down products of wear and tear, which, if 
retained, would soon destroy us. Wonderful fluid, which at one 
and the same time imparts the germs of life, and bears away the 
poisonous results of decay. 

In speaking of the food passages and organs, we have shown how 
the blood is renewed, and in treating of the blood passages and 
organs, have just explained how it is spread throughout the body. 
It now remains for us to study the means by which it is cleansed, 
namely, the waste passages and organs. 

IV. The Waste Passages and Organs. 

Every part of the body is in a constant state of change; the 
food we swallow and the air we breathe are converted into the 
natural ingredients which make up our tissues. While, on the one 
hand, we are thus constantly supplying ourselves with materials for 
repair and growth, on the other there is steadily going on within 
us a process of waste and decomposition. Thus Nature 

" Builds life on death— on change duration founds. ' 

The food we eat and convert into flesl and bone does not remain 
long in this shape, but almost immediately begins to decompose and 
pass out of the body. If the discharge of these products of de- 
composition, which represent the waste of the system, is interfered 
with, they accumulate, become poisonous, and destroy life. We 
see, therefore, that the passages and organs for the carrying off of 
the waste of the body are quite as important as those which fur- 
nish it with nutriment. These waste products pass out through 
the lungs, the skin, the liver and the bowels, but principally through 
the kidneys, which alone of all the organs of the body do not supply 
anything for our growth or sustenance, but merely expel or drain 
away that which is useless, and which, if retained, would soon be- 
come hurtful. 

The kidneys are two in number, one on each side, in the back 
part of the lower portion of the abdominal cavity. Each is about 
four inches in length, two in breadth, and one in thickness. The 



The Waste of the Body. 73 

quantity of fluid which they discharge is about two pints daily 
in a healthy adult. 

We have now seen how food is taken into the stomach, the 
manner in which it is digested, and finally absorbed by the blood, 
and how the air is taken into the lungs, and the manner in which 
it supplies oxygen to the blood, and have also learned how the 
carbonic acid and other waste substances are discharged from the 
body. It becomes, therefore, interesting to know the absolute quan- 
tity of matter thus absorbed by and ejected from the body each 
day. The healthy adult absorbs and discharges daily rather more 
than seven pounds. In the seven pounds of matter absorbed, water 
figures for nearly five pounds, oxygen for one pound, the rest con- 
sisting of the various ingredients of food. In the seven pounds 
of matter discharged, carbonic acid and the vapor of water expelled 
from the lungs figure for over a pound each, the perspiration for 
nearly two pounds, the bowels and the kidneys throwing off the 
rest. Hence it follows that in a person of the average weight of 
140 pounds a quantity of material equal to the entire weight of 
the body passes through the system every twenty days. The whole 
substance of which the body is composed is, therefore, incessantly 
renewed, under the operation of that mysterious influence which we 
term life. 



V. The Special Senses. 

We, in common with all other animals known to us, have certain 
peculiar faculties, called the special senses, by which we obtain 
information as to the things in the world about us which we could 
get in no other way. No animal is without some of these senses, 
and none has more than five of these gateways of knowledge, 
namely, the senses of smell, of taste, of touch, of hearing, and 
of seeing. Each of these, instruments of sensation has its own ex- 
elusive office. Thus, odors are only known to us through the sense of 
smell ; sounds, however loud, and light, however intense, can only be 
appreciated by the ear and eye. It is to the nerves that we are 
indebted for the conveyance of these sensations to onr minds ; and 

7 



74 Structure and Action of the Body. 

it is one of the most mysterious parts of our nature that nerves 
which are nearly alike all over the body, should, when distributed 
over the nose, the tongue, the ear, the eye, carry to our minds feel- 
ings so different. 

We shall begin the study of the special senses with that 

Of Smelling. The nose is the instrument of the sense of 
smell. The nerves of this sense, called the olfactory nerves, are 
distributed, in almost a naked condition, over the lining membrane 
of the nostrils, so as to freely expose them to the air, which bears 
the odorous particles to them when passing through the nose in 
the act of breathing. In order, however, to protect them from 
acrid odors and the undue action of the atmosphere, the nostrils 
secrete a thick, insipid mucus. 

In the acuteness of this sense we are inferior to many of the 
lower animals. In the dog, for instance, as every one has observed, 
it is very acute and delicate. Not only can he thus track different 
kinds of game in the forest, but he can recognize particular in- 
dividuals and the articles of their dress, by their odor, and even, 
incredible as it would be to us, were it not a matter of common ob- 
servation, can trace the odor of his muster's feet through all the 
winding streets of a populous city. 

It is worthy of note that the senses of smelling and of tasting 
are in all animals placed near each other. Brute animals select 
their food chiefly by the sense of smell, and even we, in this selec- 
tion, are greatly influenced by it. The two senses are, therefore, 
placed together, like two sentinels over all that which passes our 
lips. 

It is not out of place here to remark, speaking of the nose, that 
the habit of breathing through the mouth instead of the nostrils is 
an injurious one, and one that the children must not be permitted 
to form. Teach them to keep the mouth shut when not eating 
or talking. The nose is a natural respirator, furnished with 
means for wanning and moistening the air breathed, as well as 
with the sense of smell, for warning us against noxious airs and 
vapors. 

Children should not be permitted to form the habit of jpicMng 
the nose, which often gives rise to troublesome sores. If the prac- 



The Sense of Smell. 75 

tice be due to the presence of worms in the bowels, as is sometimes 
the case, the proper treatment, which we shall mention when we 
treat of that ailment, will remove the cause. 

The sense of smell is a lowly faculty, ranking below sight and 
hearing. Though we are more readily moved through the ear than 
the nose, yet to many the sweet breath of flowers in the air is as 
the warbling of music. The poets have recognized in the sweet 
scents of nature a deep meaning and a spiritual association. Thus, 
Tennyson, in his " Dream of Fair Women : " 

"The smell of violets, hidden in the green, 

Poured back into my empty soul and frame 
The times when I remember to have been 
Joyful and free from blame." 

Of Tasting. The tongue and* palate are the instruments of the 
sense of taste. The tongue, however, is more particularly the seat 
of this sense. The saliva which constantly moistens it, though 
tasteless itself, is one of the great causes of all tastes, and every sub- 
stance brought in contact with the tongue is partially dissolved by 
it before we can taste. In fevers and other diseases where the 
tongue becomes dry and coated, the sense of taste is impaired or 
annulled. 

A substance is not properly tasted until it is pressed by the 
tongue against the roof of the mouth, and, indeed, its full flavor is 
not brought out until it is actually swallowed. From this arises 
the pleasure we have in chewing and swallowing. The whole internal 
surface of the mouth and throat being thus brought around about 
the savory morsel, we have the highest enjoyment of which this 
sense is capable. 

The impression of taste lingers upon the tongue for some time 
after the substance has been ejected or swallowed. This is par- 
ticularly the case with articles very bitter or very sweet. We are, 
therefore, unable to detect and appreciate several different flavors in 
rapid succession, the taste of the first resting in the mouth mingles 
with and masks the second, and this the third, and so on. This 
fact can be utilized in giving disagreeable medicines. If some 
highly flavored and pungent substance be first taken in the mouth, 



7 6 Structure and Action of the Body. 

a nauseous draught may be swallowed immediately after, without 
discomfort. 

It has been well said that what is salutary for the stomach is 
generally pleasant to the taste. Animals are influenced more than we 
aje by the sense of taste in the selection of food ; we are governed 
a great deal by our judgment and experience, and too often by our 
prejudices, in what we eat and drink. Some persons have a natural 
aversion to particular articles of food which are ordinarily agreeable. 
Surfeit, produced by overloading the stomacb, is frequently a cause 
of disgust, ever after, for the dish so imprudently indulged in. That 
tastes may be cultivated is a matter of daily experience. Children 
should not be allowed to be finical at the table, and grow up with 
antipathies for usual and healthful articles of food. 

In health, and particularly in sickness, food that is enjoyed in 
the eating is far more nutritious than that which is indifferent or 
unpleasant to the palate. This is an important physiological fact, 
too frequently overlooked in the treatment of disease. We, there- 
fore, give, in Part Fourth, Chapter Eleventh, of this work a large 
number of choice and novel receipts for the preparation of delicacies 
for the sick table. We cannot too much insist upon the usefulness 
of pleasant flavors to secure the taking and digestion of wholesome 
food by those who most need such nourishment. 

Of Touch. The sense of feeling, or of touch, differs from 
the other senses, in being extended over all parts of the body, 
internal as well as external, while the others are confined to par- 
ticular organs situated in the head. But what is called the sense 
of touch is properly restricted to the sensation imparted by the 
contact of objects with the skin, and more particularly with the tips 
of the fingers. The sensation produced by the contact of an object 
is, however, precisely the same in character, whether felt by the 
tips of the fingers, the backs of the hands, the lips, cheeks or other 
parts, differing only in the degree of its development. 

In describing the skin, we spoke of the nipple-like elevations, 
similar to the nap of velvet, although very much smaller, produced 
by the terminations of the nerves on the surface of the skin. These 
little protuberances have received the name of paplllse. They are 
the animal feelers, the immediate instruments of the sense of touch. 




The Sense of Touch. 77 

By them we appreciate roughness, smoothness, and other characters 
of the surface of objects. They are very numerous about the 
points of the fingers. They Fig. 50. 

are well shown in the cut 
surface, greatly magnified 
of the skin of the front of 
the fore-finger, in Figure 
50. There are seen the 
branches of the nerves of 
the sense of touch, which, 
after numerous ramifica- 
tions, terminate in the 
minute protuberances, the 
papillae, shown on the sur- 
face of the true skin. The The Feelers of the Skin, 
improvement of which the sense of touch is capable, by practice, is 
illustrated by the wonderful skill acquired by the blind. 

Of Hearing. The instrument or organ of this sense is the ear, 
which collects and transmits sounds to the nerve of hearing, to be 
conveyed to the mind. It is. a very beautiful, delicate, and complex 
structure, that we will try, in plain language, with the aid of excel- 
lent, carefully-made engravings, to describe clearly to the reader. 

The ear consists of three parts: the outer ear; the middle ear, 
called also, from its character and office, the "drum;" and the inner 
ear, which, from its intricate and involved form, has also received 
the name of the' "labyrinth." There are two tubes or canals 
leading to the middle ear or drum, one from the outer ear, called 
the Auditory (that is to say the hearing) Canal, and the other from 
the throat, called, after the Italian physician, Eustachius, who first 
described it, the Eustachian tube. 

The outer ear is that expanded, trumpet-shaped, gristly portion 
at the side of the head, that we can all see and touch. Its object 
is to collect the waves or vibrations of air, which produce sounds, 
and direct them through the auditory canal, to the middle ear. In 
quadrupeds the outer ears are large, and furnished with muscles by 
which they can be erected, and carried from side to side, in order 
the better to collect the waves of sound. Although we have the 

7* 



78 Structure and Action of the Body 

same muscles, few of us can move our ears. The more prominent 
this outer ear, the better is the hearing, as is shown by placing the 
half-closed hand behind it, and so collecting, to a still further degree, 
the vibrations of the air. Those whose ears are nearly flattened to 
the side of the head, do not hear so well as others ; as the size and 
form of the outer ear varies, the sense of hearing varies also. 

From the outer ear there is a tube or canal, the auditory canal 
before mentioned, leading to the middle ear. At the bottom is a 
tightly-stretched membrane, which makes the outer wall of the 
middle ear, or the head of the drum. The auditory canal is about 
an inch and a quarter long, and slightly curved upon itself, so as to 
be higher in the center than at either end. It carries in, just as an 
ear-trumpet does, the waves or undulations of the air, collected by 
the outer ear, to the middle ear. The hairs at the entrance of this 
canal, and the wax which keeps it soft, are for the purpose of 
excluding dust, insects and other substances. The wax sometimes 
gets hard, and increases to such an extent as to cause noises in the 
ear, and partial or entire deafness. In such cases it may be removed 
by gently throwing up, from a syringe, warm water with a little soap 
in it. Children frequently fall into the habit of picking the ear 
with the finger, thus irritating it, and exciting inflammation and 
running. Many adults, also, cannot let their ears alone, but are 
constantly thrusting toothpicks, pins and needles into them, to 
clean them out. This habit often leads to permanent injury, and 
not unfrequenfly, by an accident, punctures the drum of the ear, 
and destroys the hearing. The practice which some people have of 
stopping up this tube with pieces of wool, "to keep out the cold," 
is absurd and hurtful ; absurd, because if nature intended the ear 
to be thus shut up, she would have done it herself; hurtful, as it 
heats the ear, makes it very sensitive and liable to take cold and 
become inflamed. 

Figure 51 shows the surface of a cutting made through the ear. 
a, is the auditory canal the external tube running from the outer 
ear to the drum, b, is the inner end of the eustachian tube, where 
it opens into the drum. This tube is from an inch and a half to 
two inches long, and commences at c in the upper part of the throat, 
at the back and side. It supplies the middle ear with air. When 



The Sense of Hearing. 79 

the throat is inflamed, the opening into this tube may he closed, 
and the hearing thus impaired. Some*persons, by swallowing, can 
readily force air into it, which is felt to crack in the ear. 
Fig. 51. 




Section of the Ear. 

The middle ear, the drum or barrel of the ear, is a cavity, about 
half an inch long by a quarter of an inch high and wide. It lies 
at the bottom of the auditory canal, from which it is separated by 
the thin, tightly-drawn, drum membrane, and gets air from the 
throat by the eustachian tube, just described. This cavity is filled 
with air, and is traversed by a chain of small, movable bones. 
These bones are very pretty and curious. They are three in 
number, called, from their shape, the hammer, the anvil, and the 
stirrup. The hammer is connected with the head of the drum, the 
stirrup with the oval membrane separating the middle from the 
inner ear, and the anvil is placed between the two, to which it is 
united by very delicate joints. This chain of bones, therefore, 
carries across the cavity of the drum any vibrations into which the 
drum-membrane is thrown, by the waves of air coming through the 
auditory canal, and communicates these vibrations to the inner oval 
membrane, which, in turn, sets in motion the fluid contained in the 



8o 



Structure and Action of the Body. 




Fig. 53. 



canals of the inner ear. The object of this arrangement we will 
see directly. The examination of the figure will give a better idea 
Fio . 52 than any description in words, of these 

little bones, m is the hammer, of 
which h is the handle, by which it is 
attached to the drum membrane, a 
is the anvil and s the stirrup. 

Their position and action will be 
made still plainer by Figure 53, 
which is the face of a cutting through 
the ear, made so as to show the chain 
of bones in the drum, and the outlines 
of the inner ear. 

The Little Bones in the Ear. The inner ear, or the labyrinth, 
consists of a series of arched cavities, channeled out in the sub- 
stance of the bone, shown at the left of Figure 53. It is shut out 

from the middle ear 
by an oval membrane, 
to which is fitted the 
base of the stirrup 
bone. This bony 
labyrinth contains 
fluid, and within it 
there is a closed sac, 
which has the same 
form as the bony 
passages in which it 
is inclosed. The 
closed sac, which is 
called the membran- 
ous labyrinth, also 
contains fluid, and 
within it the fine, thread-like ends of the auditory nerve, or the 
nerve of hearing, are spread out. 

Sounds are propagated by the medium of the air, being produced 
by waves or undulations in it, like to the circling ripples caused in 
still water by the throwing in of a stone. That air is the medium 




The Outer, Middle and Inner Ear. 



The Course of a Wave of Sound. 8 1 

of sound, is established, by the fact that a bell suspended in the 
receiver of an air-pump, from which the air has been exhausted, 
gives out no sound, no matter how violently it may be rung ; while, 
if air be forced into the receiver by a condenser, the sound increases, 
in proportion as the quantity of air is increased. 

Knowing now how sound is produced in the air, and how the ear 
is constructed, we can understand how the appreciation of sound or 
hearing takes place. The waves of sound strike the external ear, 
are collected and directed into the auditory canal, where, dashing 
against the drum membrane, they throw it into vibration. The chain 
of little bones in the middle ear receives the impulse, and carries it 
across the drum to the oval membrane, which is thus made to 
vibrate and communicate the motion to the fluid filling the circular 
canals and arched passages of the inner ear, and so agitate the deli- 
cate filaments of the nerve of hearing floating therein. The nerve 
so affected transmits, by its peculiar power, the sound to the brain, 
where " that which seems mere motion in the ear, and in the nerve, 
turns into joy or sorrow in the soul." 

"Hark, how the rolling surge of sound, 
Arches and spirals circling round, 
Wakes the hushed spirit through thine ear, 
With music it is heaven to hear." 



Fig. 54. 



Of Seeing. Of all the instruments of sensation, the organ of sight, 
the eye, is the noblest, the most delicate and refined. It is retained 
and moved within its bony 
socket by the aid of mus- 
cles. These muscles are 
six in number. They are 
distinctly drawn in Figure 
54, and are named from 
their office: the inner 
straight muscle (No. 3); 
the outer straight muscle 
(No. 4) ; the upper straight 
muscle (No. 2) ; the lower 
straight muscle (No. 5^i : the upper oblique ; and the lower oblique 




The Eyeball and its Muscles 



82 Structure and Action of the Body. 

(No. 6). The broad muscle which lifts the upper eyelid is also 
shown (No. 1). These four straight muscles are attached to the 
globe of the eye in such a way that they turn it inward, outward, up- 
ward and downward, as their names express. The oblique muscles 
rotate the eyes. In cross-eyes, or squint, one of these straight mus- 
cles, usually the inner, is contracted or shortened, and so draws the 
eye forcibly to that side. Children so affected should be operated 
on early by a surgeon. The operation consists simply in cutting 
through the offending muscle, so as to permit the eye to move 
freely about in its socket. 

Now that we know the muscles which enable us to turn the 
eyeball, we will have but a word to say upon the eyelids, before 
considering the internal structure of the eye. The eyelids may be 
compared to vails or shutters, designed to protect the organ of sight. 
Their borders, the eyelashes, prevent the entrance of dust and other 
foreign substances. 

The eyeball is, therefore, securely placed in its orbit, where, while 
protected from injury, it is so situated as to command a wide range 
of vision, and is freely moved in all directions by its numerous mus- 
cles, and shielded in front by its lids and their lashes. The inter- 
nal structure of the eye, and the manner in which its different parts 
concur in transmitting the rays of light and the images of objects, 
next demand our attention. 

The interior of the eye is a dark chamber, into which the light 
enters through a circular transparent membrane, called the cornea, 
fitted like a watch-glass into its front. The cornea is, therefore, the 
window of the chamber ; the rest of its circular wall consists of the 
white coat of the eye, a tough case with holes for nerves and vessels. 
The inner surface of the wall of this globular chamber is black, to ab- 
sorb the scattered rays of light. In front of the chamber, a little dis- 
tance behind the window, or cornea, there is a muscular curtain, called 
the iris, with a hole through its centre, called the pupil, which varies 
in size so as to let in more or less light as the eye wants it, becoming 
larger when the light is feeble, smaller when it is very bright and 
strong. The iris curtains off, in this manner, a sort of an ante- 
chamber in the front part of the eye. This antechamber is filled 
with a fluid, called the watery humor, in which the his hangs and 



The Passage of a Ray of Light Through the Eye. 83 



easily plays. Behind the iris is the lens, kept in place by a row of 
dark folds. The rest of the chamber is occupied by a jelly-like 
mass of a greenish hue, called the vitreous or glassy humor. These 
structures are so plainly delineated in Figure 55 that, with the aid 
of the above description, the drawing explains itself. 
Fig. 55. 




The Chamber of the Eye. 

The vitreous or glassy humor holds out, like a globe, the thin 
coat, called the retina, into which the nerve of sight spreads out 
when it enters the eyeball, and on the outer layer of which pictures 
are formed of all we see. The retina of the eye, therefore, resem- 
bles a canvas, on which forms and colors are painted, or a screen, on 
which they are thrown. 

It is easy now to trace the course of a ray of light in its passage 
through the eye to the nerve of sight. The parts just described 
bend to & focus the rays of light coming from an object, and with- 
out these parts we could only see things the size of the pupil. The 
rays of light first pass through the window of the eye, that is to say, 
the transparent outer structure, called the cornea, enter the ante- 
chamber, in which hangs the curtain, called the iris, pass through 



84 Structure and Action of the Body. 

the curtain, by the hole in its centre, called the pupil, and pierce the 
lens, which is so constructed as to converge the rays of light to a 
certain point. In passing through the chambers of the eye the 
rays of light are so bent out of their course by the parts described 
that the rays from the top of an object cross those from the bottom, 
so that the retina receives the image of an object upside down, but, 
with the mind's eye, we see it right. 

That structures so delicate as those which make up the eye 
should be sometimes defective in their action, will not excite sur- 
prise. Two defects, in particular, are quite common, namely, short 
sight and long sight. Most persons see objects, as, for instance, the 
type of this page, in the most perfect degree at a distance of about 
sixteen inches from the eye. The short-sighted hold their books 
nearer than this, sometimes very close to the eye, while the long- 
sighted hold them two feet or more away. These defects are occa- 
sioned by the quantity of water in the antechamber of the eye ; 
thus, in the short-sighted, the cornea is observed to be too round or 
bulging, while, in the long-sighted, it is too flat. Naturally, in 
youth, the eye is fuller than in middle life and in old age, so that 
the tendency of the young is to short sight, that of the old to long 
sight. It is a fact deserving attention that the number of short- 
sighted children and of far-sighted adults is increasing. Parents 
should know the causes of short sight, and take care that their 
children are not exposed to them. It is very frequently developed 
by the habit of holding books and other objects unnecessarily close 
to the eyes, or bending down the head very near to them. There- 
fore, small print, bad ink and paper, delicate- drawing, fine needle- 
work, imperfectly lighted rooms, high seats and low desks or tables, 
are to be avoided, as leading to the habit in question. 

Those who are short-sighted would do well to observe certain sim- 
ple rules for the preservation of their sight. They should naturally 
choose books with large type, and hold the book up to the eyes, not 
the eyes down to the book. Bending over a flat table in writing 
must be avoided by the use of a high desk. -No close nor fatiguing 
work should be undertaken, and the eyes must never be overtasked by 
too continuous labor, but relieved by frequent rests. In regard to 
the use of spectacles, those who are only slightly affected may 



The Brain and Nerves. 85 

usually dispense with them, but those who are affected to a con- 
siderable degree will find safety as well as advantage in their use. 
In no case, however, must too strong glasses be employed, as they 
are injurious. The short-sighted need feel no alarm, unless the 
trouble is evidently increasing from year to year, when rest, and, per- 
haps, treatment, become imperative. 

Old sight is different from long sight. Old people do not see 
better in the distance than young ; they are merely unable to see 
so well objects close at hand. This impairment of vision sometimes 
begins at the early age of thirty-five, without attracting notice ; ten 
years after, the book is held, instinctively, several inches further 
from the eyes than in youth. The impairment gradually increases 
with advancing years, until at last the book has to be held so far 
that the letters can no longer be distinguished, and all reading 
without glasses becomes impossible. This defect is remedied by 
spectacles, which have to be made stronger and stronger with invad- 
ing years. When the glasses habitually employed have to be put 
at a distance, and kept on the tip of the nose in order to render 
them of service, stronger ones should at once be obtained, and the 
eyes not fatigued by attempting to make the old ones do. The 
glasses should be sufficiently strong to permit of the book or news- 
paper being held within a foot of the eye. 

Weak eyes frequently result from reading, drawing or sewing, in 
a light either too bright or too dim. The full glare of the sun and 
twilight are equally injurious. The practice of reading in bed, or 
when lying on a lounge, is also often a cause of weak eyes. It is 
better, therefore, always to sit up to read. 

VI. The Brain and Nerves. 

The muscles, the organs, and the other parts of the body which 
have occupied us thus far, are acted upon and ruled over by the 
nerves, the servants of the brain. The nerves not only excite, but 
control and regulate all the actions of the body. 

The nervous system consists of three great parts, the brain, the 
spinal cord, and the nerves. Our noblest part, the brain, is situated 
within the skull. By it we feel and will, think and remember. 



86 Structure and Action of the Body. 

The spinal cord is a long, nervous, cord-like mass, about the thickness 
of a finger, extending from the brain to the base of the spinal column, 
the cavity of which it occupies, constituting what is called, in 
common language, the spinal marrow. It gives off thirty-one 
pairs (one nerve for each side) of nerves ; eight in the neck, twelve 
in the back, five in the loins, and six in the haunches. These nerves 
arise by two roots from the cord — a back one, which brings feeling 
to the cord, and a front one, which carries orders to the muscles. 
As these roots unite together, they thus spread over the whole of the 
body the powers of sensation and motion. The brain gives off nine 
pairs of nerves, among which are the nerves of the sense of smell, 
of sight, of hearing and of taste. 

Figure 56 shows the brain, the 
spinal cord, and the manner in which 
the nerves branch off from them. 

These thirty-one pairs of spinal 
nerves go to the muscles and coverings 
of the neck, trunk, and extremities, 
and impart to them the power of feel- 
ing and the power of motion. This 
transmission of feeling and of motion 
•through the nerves is effected in a 
very beautiful manner. Each spinal 
nerve, as we have just mentioned, 
arises from the spinal cord by two 
slender threads or roots. The back 
root conveys sensation or feeling to the 
cord, while over the front root passes 
the impulse of motion. Each of 
these front and back roots extends up 
along the spinal cord to the brain, on 
the one hand, and, on the other hand, 
is continued along the nerve of which 
it makes a part, throughout its whole 
course. When we touch anything, 
The Braln^Stfnal Cord, and ^ impreesion pro duced on the skin is 
conveyed along that slender thread of the nerve which carries 




The Domain of the Brain. 87 

feeling, and the back root of the nerve, to the spinal cord, and 
thence upward along its prolongation in the spinal cord to the 
brain, where it causes a sensation corresponding in character to the 
impression made. In this manner we feel or have the power of 
sensation. When, on the contrary, we desire to move a muscle, 
the impulse of motion which we originate in our brain passes down 
the spinal cord, along the continuation of the front root of the 
spinal nerve, and over the front root and its prolongation in the 
nerve and branches, until the muscle to which the message is sent 
is reached. In this manner we move our muscles, or have the 
power of producing motion. We see, therefore, that each nerve is 
made up of two very different fibres, one conveying sensation and 
the other motion; that these fibres separate at the spinal cord, 
constituting the front and back roots of the nerve ; and that they 
are prolonged up through the spinal cord to the brain, putting 
it thus in telegraphic communication with every part of the body, 
for the receipt and transmission of messages. It is easy now 
to understand why it is that, when, by accident or disease, the 
spinal cord is severed or destroyed at one spot, all motion 
and sensation in the parts of the body below that spot cease, and 
that paralysis and insensibility are the necessary consequence of the 
cutting off of the communication of these parts with the brain, the 
great seat of sensation and motion. 

It is by and in the brain that we feel ; it is there that all impres- 
sions made upon our bodies are converted into conscious sensations. 
These sensations are, in a condition of health, at once referred to 
their proper source, so that we seem to feel in the part affected. 
When, for instance, the finger is pricked, it is the brain which 
feels the pain and not the finger. That the brain is the seat of 
sensation is shown by the fact that if the nerves connecting it with 
any part be cut, that part cannot be made to feel or suffer. 

Not only is the brain the seat of feeling, but of all voluntary 
motion. Every time we designedly move a muscle, we do it by a 
mental effort, that is to say, by an act of the will. In speaking of 
the muscles of the body, in the first chapter of this book, we said 
that the muscles are of two kinds, voluntary and involuntary, and 
that those which perform actions which require to be unremittingly 



88 Structure and Action of the Body. 

kept up to sustain life, such, for instance, as breathing and the 
beating of the heart, are fortunately independent of our minds. . 
These involuntary actions are carried on through the spinal cord. 
There is, therefore, no mind in them, otherwise death would soon 
result. All the involuntary actions of the body devolving upon 
the spinal cord, which keeps them up without consciousness or 
effort on our part, the mind is left free for the higher life of thought, 
and feeling, and design. Even voluntary actions, when habitual, 
soon need so little attention that they cease to occupy much of our 
thoughts. Thus we hold ourselves erect, walk and talk, without a 
conscious effort, although the numerous muscles concerned in these 
very complicated and difficult acts are all worked by the will. Thus, 
also, the hand of the practiced workman or the skillful artist glides 
over his work almost unconsciously, while the beginner bungles, in 
spite of the closest attention. 

From the above sketch of the nervous system, it will be seen in 
what intimate relations the brain is kept, by the nerves, with 
external objects. Hence the supply of wholesome impressions 
through the special senses, the lungs and the skin, largely contributes 
to mental health. Fresh air and pure water are not only useful to 
the lungs, and skin, and blood, but directly to the nervous system, 
which they tone up. Pleasant sights and sounds are excellent 
mental tonics. Everything that brings happiness is a cordial to the 
brain and nerves. These are elementary principles in mental 
hygiene which all should know and heed. 




PART II. 
SICKNESS IN ADULT LIFE. 



THE DIVISIONS OF THIS PART. 

Thus far we have been occupied with the structure and action 
of the body. The ailments of the body, their prevention and treat- 
ment, now demand our attention. For convenience of arrangement, 
as well as because of the different nature of the complaints, we 
shall first take up the ailments of adults and then those of children. 

Before entering upon the study of the special maladies to which 
the body is liable, some general directions on the manner of keeping 
the chamber, and of caring for the persons of the sick, and upon the 
use and administration of remedies, are necessary. Of the four 
chapters of this part, on Sickness in Adult Life, the first, therefore, is 
devoted to the Domestic Management of the Sick Room ; the next 
treats of those Ailments — such as fevers, for instance — which assail 
the Entire Body ; the following discusses those — such as pleurisy, 
for instance — which attack a Particular Organ or Part ; while the 
concluding chapter is given to Accidents, Injuries, and Emergencies 
of various kinds. 

8* 89 



CHAPTER III. 

THE DOMESTIC MANAGEMENT OF THE SICK ROOM. 

Choice of the Sick Room— Its furniture— Air and ventilation— Hints in 
regard to its warmth— How it should be lighted— The importance of 
cleanliness— Duties and deportment of those nursing the sick— Personal 
attentions required by the sick— Management of those recovering from 
sickness— Household remedies— Family thermometry. 

Choice of the Sick Room. The room in which a person is 
confined to bed with a serious and protracted ailment should be 
large, lofty, and well ventilated; the window sashes ought to lower 
from the top as well as raise from below, and work with as little 
noise as possible. Walls painted in oil are better than those in 
plaster or paper. The door must be noiseless, with a ventilator 
over it or made in one of the pannels. A painted or polished 
floor is better than a carpeted one. It should be swept, or at the 
most lightly wiped, but not frequently washed, as the slow evapo- 
ration from the wet boards renders the room injuriously damp. 

The room should be a light one, exposed to the direct rays of 
the morning and mid-day sun. Blinds and shades should be pro- 
vided, for modifying the light when desirable. 

Warmth of the Sick Room. As we have said, a thermometer 
should always be in the invalid's room, and by it the temperature 
must be regulated. The best temperature is that of 60°. If, how- 
ever, the patient feels chilly at this temperature, it may be raised three 
or four degrees. In fevers and diseases of the nervous system a 
lower temperature is preferable, about 50° ; while in consumption 
and other affections of the chest an atmosphere of 65° is the most 
agreeable to the inflamed air-passages. 
90 



Furniture of the Sick Room. 91 

In the early morning hours a sick person is apt to he chilly, 
which is just the time when the room is usually the coolest — a fact 
that must be borne in mind, and precautions taken, lest the patient 
suffer serious injury from this cause. 

A low-down grate is much the best way of warming the sick 
room. 

Furniture of the Sick Room. All unnecessary furniture must 
be banished from the room. There is no need of any wardrobe, 
bureau, trunks or bandboxes. Two tables, at least, are wanted ; one 
of them should be small, and on casters, so as to roll easily to the 
side of the bed, for the immediate use of the patient ; the other, a 
larger one, for the reception of medicine bottles, spare glasses, cups, 
spoons, and other articles in constant use. In the drawer of the 
latter table there should be constantly kept a sponge, a bundle of 
soft old linen, a pair of large, and another of small scissors, a full 
pin-cushion, needles and thread, a piece of adhesive plaster, and one 
of isinglass plaster, and oiled silk for covering poultices. A third 
table, if there be room for it, is useful as a dressing table, on which 
to place the brush, comb, and other toilet articles. Over it a look- 
ing glass may be hung, but never in such a position as to permit 
of the invalid seeing himself in it as he lies in bed. A movable 
washstand, on casters, so that it can be readily shoved to the side 
of the bed, is very useful. An ample supply of clean towels should 
be constantly on hand. There ought not to be more than three 
chairs, of which one should, if possible, be an easy or reclining 
chair. A lounge or sofa is of great utility, particularly during 
recovery, when the sitting posture cannot be long maintained ; it is 
of service, also, for the patient to recline upon, when his strength 
permits, while his bed is being made. The bedstead should not be 
too wide. A greater width than three and a half feet renders it 
often difficult to reach and move the patient. Two bedsteads are 
much better than one. Each should be provided with its own 
sheets and cover. The patient passing half the time in one, per- 
mits the entire bedding of the other to be thoroughly aired out 
of the room, a very important measure in prolonged illness. The 
bedstead must be low, so as to permit of the patient getting in and 
out easily, and of his being lifted and moved with facility. Iron 



92 Domestic Management of the Sick Room. 

bedsteads are much to be preferred to wooden ones. The bed 
should be without curtains, and placed with its head to the wall, so 
as to admit of access on each side. It is best placed between two 
windows, or at the side of a window. The bed clothing must be 
light. Heavy cotton counterpanes and Marseilles coverlets must be 
discarded from the sick bed, and only good light blankets employed. 
The pillow-cases and sheets are better of cotton than of linen, and 
should be frequently changed ; daily, in the case of infectious fevers. 
The pillows must be firm and elastic, and arranged so as to support 
the back, and not piled up in such a manner as to thrust the head 
forward upon the chest, and so increase the difficulty of breathing. 
The bed should be level, and not too hard. Curtains and heavy 
drapery of all description are objectionable in a sick room, as they 
harbor dust and contagious matter. Besides these main pieces of 
furniture, there are a number of articles of use in every sick room. 
Among these we may mention the following, viz. : a thermometer 
(one so constructed that it can be put in water to get the heat of a 
bath) should hang on the wall, at the height of the bed ; a fool 
warmer, which may be made of a common bottle filled with hot 
water, or of a rubber bottle or cushion, or an earthenware bottle 
sold for the purpose, should be at hand when wanted ; a stomach 
warmer, made of an India-rubber bottle or bag filled with hot 
water, is often of use ; air and water cushions, or a cushion in the 
shape of a ring, filled with bran, are serviceable in warding off 

Fig. 57. 




Supporting Cradle, 
pressure from prominent parts, giving support, etc.; a pillow rest, 
made of a bag of the same width, but twice the length, of a pillow 
case, stuffed with hay, straw or oat-chaff, in such a manner as to 
make it taper down like a writing desk, from back to front, is an 



Articles for the Sick Room. 93 

excellent thing for propping up pillows ; a cradle, such as is repre- 
sented in Fig. 57, to support the bed-clothes, and prevent them 
pressing upon a painful part, is useful in many ailments ; folding 
rests for the legs, made in the shape of an open book, and covered 
by a blanket, give comfort to the weary limbs ; a medicine glass, 
marked so as to measure exactly a teaspoonful, a dessertspoonful, 
and a tablespoonful, enables medicine to be given with much greater 
exactitude than can be done with spoons, which vary in size ; a 
medicine spoon, which can be obtained at most druggists', permits 
of medicines being administered to very weak and partially uncon- 
scious patients, as it is covered, and has an' opening near the end, so 
as to avoid all spilling; a feeder, consisting of a half-covered vessel 
furnished with a spout, for giving soups, teas, and other fluids, is 
convenient for administering drinks to the patient when lying in 
bed ; a bed-side pocket, to be pinned at the side of the bed, makes 
a convenient place for keeping the pocket handkerchief, a bottle of 
scent, etc., within the reach of the invalid ; a sick tray, consisting 
of a board hollowed out in front to fit the body, and supported on 
four short legs, to be placed on the bed before the patient, is often 
much more convenient than an ordinai-y waiter on the knees or a 
table at the side of the bed ; a bed-chair is often of service ; a bed- 
pan, or slipper, is necessary for those too weak to. rise from the bed ; 
two baskets, with divisions or compartments, are useful for medicine 
bottles, one containing medicines for internal use, the other, of 
another color and form, containing external applications ; and two 
baskets for cups and dishes, one for those needing washing, which 
are to be quickly sent out of the room and exchanged for the other 
basket with its clean ware. The following articles must not be 
kept in the sick room, viz. : dirty linen, implements of cooking, pre- 
pared food, medicines discontinued by the physician, soiled cups 
or glasses, slop basins or pails. 

Air of the Sick Room. Fortunately the prejudice against ad- 
mitting fresh pure air into the chambers of the sick, particularly of 
fever patients, is to a great extent a thing of the past. The custom 
of almost hermetically sealing the rooms of patients in fever was 
very prevalent among nearly all classes, some forty or fifty 
years ago. Dr. James Gregory, of Edinburgh, the celebrated pro- 



94 Domestic Management of the Sick Room. 

fessor of medicine ; used to mention in his lectures, that as no argu- 
ment was of avail in procuring the admission of fresh air into the 
sick rooms of the poor, he generally pushed his cane through the 
panes of the windows. This, however, was not always adequate to 
insure the intended effect, as he often found the broken panes 
pasted over with paper on his next visit. No such forcible measures 
are now, usually, required. People generally err from carelessness 
rather than ignorance or prejudice, as few can be unaware of the 
fact, the subject having been so widely discussed, that foul air is 
poisonous for sick and well. In many cases, it is useful, once or 
twice a day, to cover the patient well in bed and protect him from 
drafts, and then open wide all the doors and windows, so as to wash 
out the room with fresh air. An excellent test for foul air is the 
nose; pure air is tasteless and free from all smell. 

The air of the room should never be permitted to become too 
dry, as is the tendency in heated rooms in winter. A basin of 
boiling water occasionally brought into the room, and replaced by 
another when it becomes cold, will usually give sufficient moisture. 

A constant supply of pure air is important for others in the sick 
chamber as well as for the patient, as it lessens their chance of con- 
tracting the disease. The confinement of a contagious principle in 
a close room increases its force; the more poisonous emanations 
are diluted by admixture with fresh air the less dangerous they 
become. Hence certain diseases are more frequently propagated in 
winter, when doors and windows are kept shut, than in summer, 
when the outside air is freely admitted. 

While keeping the air that the sick breathe fresh and pure, by 
ventilation, care must be taken not to chill the patient. There is 
little danger, however, with ordinary precautions, of taking cold 
when lying in bed. Sick people usually catch their colds by rising 
for a moment from a warm bed without throwing any wrap around 
them, or by sitting up in bed without a covering over the shoulders. 

Of course, no air is pure which contains smoke from a badly- 
made fire, or from the chimney of an oil lamp. Not only smoke, 
but gas, frequently escapes from a stove, and proves a source of 
trouble to the sick, particularly those affected with chest ailments. 

Of all the sources of contamination of the air of the sick chamber, 



How Invalids are Poisoned. 95 

one of the worst is the chamber utensil. On this subject, Florence 
Nightingale, with her usual good sense and thoroughness, writes : 
" The use of any chamber utensil without a lid should be utterly 
abolished, whether among sick or well. You can easily convince 
yourself of the necessity of this absolute rule, by taking one with a 
lid, and examining the under side of that lid. It will be found 
always covered, whenever the utensil is not empty, by condensed 
offensive moisture. Where does that go when there is no lid ? 
But never, never should the possession of this indispensable lid 
confirm you in the abominable practice of letting the chamber 
utensil remain in a patient's room unemptied, except once in twenty- 
four hours. Yes, impossible as it may appear, I have known the 
best and most attentive nurses guilty of this. Earthenware, or if 
there is any wood, highly polished and varnished wood, are the only 
materials fit for patient's utensils. A slop pail should never be 
brought into a sick room. It should be a rule invariable, that the 
utensil should be carried directly to the water-closet, emptied there, 
rinsed there, and brought back. There should always be water and 
a cock in every water-closet, for rinsing. But even if there is not, 
you must carry water there to rinse with. I have actually seen, 
in the private sick room, the utensils emptied into the foot pan, 
and put back under the bed. I can hardly say which is most 
abominable, whether to do this or to rinse the utensil in the sick 
room. In the best hospitals, it is now a rule that no slop-pail shall 
ever be brought into the wards, but that the utensils shall be car- 
ried direct, to be emptied and rinsed at the proper place. I would 
it were so in the private house." 

In typhoid fever, dysentery, and other similar affections, in which 
the infectious principle of the disease resides in the discharges, the 
chamber utensil, so soon as it is cleaned, which should be at once 
after use, should have poured into it about half a tumblerful of a 
strong solution of sulphate of iron, kept on hand for the purpose in 
a large bottle or jug, and made by dissolving a pound of copperas 
in a gallon of water. Directly after the vessel is used, and before 
its contents are emptied, about a tumblerful of the same solution 
should be poured in, to destroy the fetor and lessen the liability of 
infection. 



96 Domestic Management of the Sick Room. 

Light of the Sick Room. The sick require plenty of light as 
well as an abundance of air. It is only in the beginning and 
violent stages of certain diseases, and in some nervous affections, 
that it is advisable to partially darken the room. 

It is a fact in regard to which there can be no doubt, that the 
sick do better and recover more quickly in a sunlit room, than in 
one into which its rays cannot enter, or from which they are always 
excluded. An agreeable view from the window is also desirable, 
especially during convalescence, to relieve the tired eye, and gratify 
the craving, nearly always experienced, for looking out of the 
window. 

The night light must be so placed as not to throw a shadow on 
the ceiling over the patient, or on the wall in front of him. Shadows 
of things or persons in the room often assume, to the fearful gaze 
of the weakened patient, forms of terror, and may excite delirium or 
even convulsions. If oil be burned, care must be taken that the 
lamp does not smoke nor smell ; if gas, that the gas does not escape. 

Cleanliness of the Sick Room. Cleanliness and order are 
important in the chamber in which the sick lie, but the dust and 
noise made in sweeping and arranging the room are frequently a 
source of great annoyance to the silent sufferer. As after a night's 
rest the patient is best able to bear a little bustle, the morning 
should be selected for putting the room to rights. If there be a 
carpet on the floor, it is to be sprinkled with moist tea-leaves before 
being lightly swept with a hand-brash and dust-pan. 

The furniture, the bed and bedding, the floor and walls, and 
every article in the sick room, should be always clean. No vessel 
or implement used by the patient should be suffered to remain in 
the apartment, but be at once taken out, to be returned so soon as 
cleaned. Every glass, cup or plate in which food is administered, 
must be taken immediately out of the room and washed. Neither 
ought any glass or spoon in which medicine is given be suffered to 
remain with the small portion which is always left in it ; it must be 
instantly and well cleansed. 

Duties and Deportment of those Nursing the Sick. Those 
women make the best nurses for the sick who are between the 
ages of twenty-five and fifty-five, active and vigorous, in good health, 



Duties of Nurses. 97 

of happy, cheerful disposition, with kind feelings, and a temper not 
easily ruffled, and of orderly, clean and neat habits. 

The nurse should cook nothing in the sick room ; move about 
without noise, fidget, hurry or bustle; keep the room in order, 
sweet and clean ; take out of the room instantly all evacuations of 
the patient, slops, soiled linen and wet towels; avoid eating any- 
thing that gives a bad smell to the breath ; order food so as to have 
it ready promptly at the time for giving it ; observe minutely the 
orders received for administering food and medicine ; see that the 
patient's mouth and nostrils remain uncovered during sleep ; never 
express a doubt in regard to the propriety or efficacy of the treat- 
ment employed; always look confidently for recovery; make no 
comparisons with other cases; say nothing to discourage or alarm 
the invalid ; never whisper ; give no prohibited food, and permit of 
no forbidden indulgences ; see that there is a supply of fresh air, 
and that the patient is kept out of all drafts ; preserve a proper 
uniform temperature, by means of the thermometer. 

She should also keep in writing, jotting down at the moment, the 
exact time, by the watch, of all the important events of the day, 
such as the taking of food and medicine, the coming on of sleep, or 
delirium, or restlessness, the dejections of the patient, any remarkable 
change in the symptoms, and other matters of interest bearing upon 
the progress of the ailment and the condition of the patient. For- 
tunate is he who has a wife, daughter, mother or sister who can 
fulfill these requirements, and sensible is the woman who tries to fit 
herself, by thought, reading and observation, to take care, in a proper 
manner, of those dear to her, in their hours of pain and weakness, 
under the shadow of death. 

The dress of the attendant on the sick is deserving of attention. 
It should be neat and clean, of a soft, warm color, and of a material 
which will wash. Black is always nasty to the delicate sense of 
smell of the sick. A dress that rustles must never be worn in the 
sick room. Creaking shoes or slippers are, of course, improper. In 
many cases of illness, particularly if the room be not carpeted, it is 
well to have a pair of large loose slippers outside the door, to be 
slipped on over their shoes, by those entering, not excepting the 
doctor. 



98 Domestic Management of the Sick Room. 

Personal Attention Required by the Sick. When there is 
a tendency, which exists in many diseases, to coolness of the sur- 
face of the body, heat should be kept up by means of hot water 
bottles, warm bricks, or tin cans filled with hot water, etc., applied 
externally. 

The skin of the patient must be kept clean by sponging with 
tepid water, to which a little whisky or vinegar may be added. 
Care must be taken while thus cleansing the skin, not to expose 
the person to a draft, and not to uncover more of the body than is 
necessary at one time. This sponging of the entire person may be 
repeated, in most cases with advantage, every day. In any event, 
the patient's face and hands should be washed every morning, and 
the feet at least twice a week. Recovery is retarded in cases in 
which the disease is assisted by the presence of dirt. 

The bed should be tidied and put straight every day, and the 
sheet upon which the patient lies should be kept smooth and free 
from crumbs. 

The body linen must be changed at least once a week, in most 
cases oftener. The following rules in regard to changing are 
useful : — 

1. Do not begin to change until all that is likely to be needed 
is ready. 

2. See that there is no draft from an open window or door. 

3. Have the fresh linen well aired and warmed beforehand. 

4. Avoid moving or uncovering the patient more than is abso- 
lutely necessary. 

5. Do not call upon the patient for too much help. 
Delirious patients must, of course, never be roughly dealt with, 

neither must they be argued with or contradicted in their asser- 
tions. It is best to appear interested in their conversation, while 
watching over and controlling with gentleness but firmness all their 
actions likely to do them injury. Such patients should never be 
left alone, nor should one person be in attendance without being 
able to call for immediate assistance at a moment's notice. 

For rules in regard to cooking for the sick, and for special re- 
ceipts for the invalid's table, see Chapter IX, commencing on page 
320. 



Home Treatment. 99 

For directions in regard to giving baths, and applying blisters, 
cups, leeches, poultices, etc., see Chapter X, page 332. 

Management of those Recovering from Sickness. Quiet 
and rest are essential in every recovery from sickness. The mind 
as well as the body demands repose after suffering. Any prolonged 
or violent exertion or mental excitement is, for a long time after 
recovery has set in, injurious, and may occasion a relapse. 

After every illness, as soon as the invalid becomes strong enough, 
a change of air and scene is of the utmost service. To those living 
in the city, a visit to the country is especially useful. The sick 
must not, however, be deprived of home care and comforts too 
soon. A journey, however short, is always fatiguing to the feeble, 
and a removal to a new abode, always a source of excitement and 
some discomfort to those not long from a bed of sickness. When 
the proper time arrives, the return of health is greatly facilitated by 
a judicious change of residence for a while. 

Household Remedies. The articles which are used to restore 
the sick to health are often and conveniently divided into "house- 
hold remedies " and " drugs." By the former, those articles are 
understood which are found in every grocery store and household, 
which are bought and kept for use in health, but possess medical 
properties, sometimes very valuable ones. Such, for example, are 
salt, mustard, vinegar, oil, spices, ginger, etc. An acquaintance 
with their virtues as medicines, and their proper use in curing dis- 
ease, is an acquisition which every one ought to make. Often such 
simple articles answer the purpose much better, with more prompt- 
ness, and at less cost, than the more unknown products of the 
apothecary shop. 

In the latter, the numerous bottles and drawers, with their labels 
in large letters, presenting strange words and mysterious abbrevia- 
tions, bewilder the ordinary visitor. He is deeply impressed with 
the difficulties in the study of physic; and the danger of meddling 
with what he knows is often poisonous is present to his mind. 
These sentiments are just, for many of these drugs are dangerous, 
others are rare and costly, others difficult to prepare and administer. 
It is not wise for any one who has not seriously studied medicine to 



ioo Domestic Management of the Sick Room. 

tamper with them, and hence, in such a manual of domestic practice 
as this, it would be inexcusable to recommend them. 

Fortunately, it is not necessary. Although there are so many 
hundred drugs in every pharmacy, their multiplication is a matter . 
of trade rather than necessity. The most learned and successful 
physicians do not use very many remedies. Probably the essential 
parts of a hundred prescriptions from their hands would, in ninety 
cases, be found in less than ten different drugs. 

We propose, in this work, to take advantage of the same principle 
of selection, and shall make the reader familiar with a limited 
number of drugs of wide application, and which have the further 
advantages of being not costly, not dangerous, and of decided vir- 
tues. They can be used in many different complaints, and in the 
forms which we shall recommend are peculiarly suitable for those 
to use who have not studied the details of the druggist's trade and 
the physician's calling. They will be often referred to, and when 
they are once provided in the family, we shall endeavor to render ' 
them sufficient for the treatment of nearly all ordinary diseases, 
supplemented, as we shall presume them to be, with those "house- 
hold remedies" to which we have already referred. 

It would be advisable, therefore, for every one who intends to 
make practical use of this book to obtain these remedies, a list of 
which we shall presently give. They should be carefully put up 
and kept in a locked chest or box, where children cannot get at 
them. All the articles can be had of any druggist, though, as some 
of them are often adulterated, and others spoil if kept too long, care 
should be exercised in their purchase and preservation. 

Sometimes, when several drugs are mingled, they act differently 
and more successfully than either of them (or any other substance) 
when taken alone. This is why, in most prescriptions or recipes, 
one sees three or four or more articles mentioned. Another ad- 
vantage, and a very great one in children and delicate persons, is 
that it gives the chance to conceal the taste of a disagreeable drug, 
and often to render it quite palatable. 

Many of these firms keep on hand medicine chests containing a 
select assortment of such drugs as are most commonly used by 



Domestic Management of the Sick Room. ioi 

emigrants, missionaries, ship-captains, and others remote from 
apothecary stores. 

The number of these offers a wide choice, as not all are selected 
with reference to the great principles which should govern the 
selection of medical agents for popular use, which we take to he 
(1) that they are efficient; (2) that they are not dangerous; (3) 
that they do not readily spoil by time and change of temperature ; 
(4) that they are not distressingly unpalatable ; (5) that they are 
not too bulky ; (6) that they are not very costly. Of the 
" Family medical chests" which have come under our notice, we 
like, as well as any, and in some respects better than any, that 
which has been sold by the "Medical Commission Agency," in 
Philadelphia (115 South Seventh street) . It is called " The Traveler's 
Medical Kit," and having been carefully selected with a view to 
the above requirements, may serve as a sample of them. Its 
contents have been more or less changed, from time to time, as 
improvements in the manufacture of drugs seemed to suggest. 
Lists can be obtained from the Agency, giving their prices and 
contents. 

In Part IV of this work a number of selected receipts will be 
given which will answer the above requirements, and which will 
be freely referred to under the treatment of diseases. Any of these 
can be obtained from the apothecary store, and, if used according 
to directions, will answer a good purpose. A number of them 
might be prepared and kept on hand ready for use. Others, which 
will be spoken of, are the following : — 

Ammonia, or Hartshorn. The preparations of ammonia which 
will be referred to are, first, the "aromatic spirits of ammonia," 
a valuable stimulant, serving in place of alcoholic fluids. The dose 
of it, for an adult, is twenty drops, in a tablespoonful of water, 
repeated when necessary. Second, the solution of the acetate of 
ammonia. A tablespoonful of this, in a wineglass of water, is 
the quantity for an adult. It acts on the skin and kidney, and is 
very cooling in fevers, and similar conditions. 

Bromides. These are the bromide of potassium or of sodium. 
They are given to allay pain and nervousness, in doses of 20 or 30 
grains. 

9* 



102 List of Medicines. 

Iodine. Tincture of Iodine, which is iodine dissolved in alco- 
hol, is frequently used as an external application, to cause gentle 
counter-irritation, and remove swollen glands, chilblains, stiffness of 
joints, slow rheumatism, etc. The iodide of potassium, dose ten 
grains, and syrup of iodide of iron, dose half a teaspoonful, are 
very valuable "alteratives," that is, they "alter" the general con- 
ditions of the body. 

Opium, one grain of which is an adult's dose, is generally given 
as laudanum, which is opium dissolved in alcohol, one grain in 
twenty drops ; or morphia, which is a chemical extract of opium, 
one quarter of a grain of which equals one grain of opium; or 
paregoric, which contains one grain of opium to an ounce; or as 
Dover 1 8 powder, which has one grain of opium in each ten. All 
these must be used with caution. 

A Thermometer is useful, not only to maintain the air of a sick 
room at a proper temperature, and to test the heat of warm baths, 
foot baths, and lae like, but in the hands of a judicious person, is 
a great aid in deciding the severity of a case of disease, by ascer- 
taining the temperature of the patient. For this purpose, the 
instrument is so made that its bulb can be placed under the tongue 
or in the arm-pit. Hold it there three or four minutes, and you 
have the temperature of the skin and blood of the patient. This 
should not be above 99°. nor below 97°. Any material variation 
from these limits indicates danger, although the symptoms in other 
respects do not appear threatening. " Family Thermometers " 
have been devised, with a zero, showing the animal heat in health, 
so that any deviation from it is perceptible by the most inexperi- 
enced hand. 




CHAPTER IV. 

AILMENTS AFFECTING THE WHOLE BODY. 

Ailment attended with Fever as the Prominent Symptom: — Typhoid 
Fever — Typhus Fever — Bilious Remittent Fever — Chills and Fever — 
Break Bone Fever — Catarrhal Fever— Yellow Fever — Small Pox — Milk 
Sickness. Ailments attended with Pain as the Prominent Symptom: — 
Neuralgia — Headache — Rheumatism — Gout — Lockjaw. Ailments at- 
tended with Sleeplessness as the Prominent Symptom: — Wakefulness — 
Delirium Tremens. Ailments attended with Wasting as the Prominent 
Symptom : — Starvation — Scrofula — Poverty of the Blood — Night Sweats — 
Dropsy. Ailments attended lo-ith Insensibility as the Prominent Symp- 
tom : — Fainting — Apoplexy. Ailments attended with Fits as the Promi- 
nent Symptom : — Falling Sickness — Hysterics — St. Vitus' Dance. 

I. Ailments attended with Feyer as the Prominent 
Symptom. 

Typhoid Fever. This disease is frequently spoken of as slow 
nervous fever, and sometimes as common continued fever. It also 
bears the names of putrid fever, autumnal or fall fever, and night- 
soil fever. 

How Brought On. Exposure to foul air, as that of sewers, 
water-closets, privy- wells, etc., is one of the most powerful causes 
of typhoid fever. Depressing influences, such as anxiety, home 
sickness, great fatigue, seem to occasion it in some instances. The 
discharges of the patient may, if not disinfected, impart the disease ; 
wells have been contaminated in this way, so that their water has 
become a source of wide-spread contagion. The age at which 
typhoid fever is most apt to occur is between fifteen and thirty 
years, rarely before ten, and still more rarely after fifty. The ap- 
103 



104 Diseases of Adit Its. 

pearance of the disease does not seem to be influenced by climate 
or locality. 

How Distinguished. Typhoid fever is usually preceded for 
several days by headache, loss of appetite, prostration of strength 
and great disinclination to make any physical or mental exertion. 
Bleeding from the nose is often an early symptom, so also is a 
slight cough. Increasing weakness and the coming on of fever 
force the patient to take to his bed. Considerable fever and thirst 
are then complained of. The nights are wakeful and delirious ; 
the days are passed in dozing and muttering. Soon, towards the 
close of the first week, the belly swells, and diarrhoea ordinarily sets 
in about the same time. The face takes on a dull look, and a dark 
purple flush. Hardness of hearing is not unusual about the middle 
of the second week. Towards the close of the second week, a few 
small rose-colored spots, which are peculiar to the disease, show 
themselves on the belly ; they disappear for a moment when pressed 
upon by the finger, but quickly return after the pressure is removed. 

Recovery may begin at the end of the second week, but ordi- 
narily not before the fourth week, while the attack, in rare cases, 
lasts two or three months. Great wasting of the body and trouble- 
some bed-sores accompany protracted cases. 

The patient gets well very slowly, and is liable, for a long time, 
to a relapse. About one case in twenty ends fatally, death taking 
place usually in the neighborhood of the eighteenth or twentieth 
day. 

How Treated. Good nursing is of more consequence than medi- 
cine in typhoid fever, as there is no remedy known which will cut 
the disease short. At the outset, if the bowels are costive, a tea- 
spoonful of castor oil, or half a tumblerful of the effervescing solu- 
tion of citrate of magnesia (to be obtained of any druggist) may be 
given ; afterwards, however, no purgative is to be ever administered. 
When the diarrhoea becomes excessive, half a wineglassful of lime 
water mixed with an equal quantity of milk, is an excellent sooth- 
ing drink. Headache is best relieved by cutting the hair short and 
applying iced cloths, or, in severe cases, pounded ice enclosed in a 
bladder or rubber bag. To allay heat of the skin, sponge the body 
with slightly warm whisky and water, or vinegar and water, care 



Typhoid Fever. 105 

being taken to expose only one part at a time to the air. If much 
pain and tenderness of the bowels be complained of, apply a large 
hot mush poultice, mixed with one-fourth part of mustard. Great 
attention must be paid to preventing bed-sores, by keeping the bed- 
clothes always smooth, by frequently changing the position of the 
patient, and by bathing the parts most pressed upon with whisky, 
or with a mixture of spirits of camphor and sweet oil. 

The diet is of the utmost importance in the treatment of typhoid 
fever. Neither during the sickuess, nor for a long time after re- 
covery, should solid food be given. A neglect of this caution often 
causes the death of the patient, by occasioning a rupture of the sore 
places which always exist in the bowels in this disease. Although 
fluid, the diet must be supporting. The quantity given at a time 
must be small, not much more than a wineglassful, so as not to 
distend the stomach, but it is to be repeated frequently, every hour 
or two. An excellent diet is a wineglassful of milk, to which a 
tablespoonfui of lime water is added, given every two hours ; in 
the alternate hours, a wineglassful of beef tea. Receipts for making 
beef tea will be found on page 326. Great care must be taken not 
to let the patient sink, from the want of frequently repeated concen- 
trated liquid food. Iced lemonade or ice water may be taken to 
quench the thirst, but not more than a wineglassful at one time. 

As to medicines, few are required. A laxative may be given at 
the outset of the disease, as already mentioned. For a tonic, 
quinine is excellent. Few cases are treated without it at the 
present day. A good way of administering it is to procure it in 
powders, of two grains each, from the druggist, and give one of 
these three times a day, in a spoon, surrounded with scraped apple, 
which will disguise the bitter taste. 

How Prevented. Foul air and water, being the great causes of 
typhoid fever, must be avoided. Hence, close, badly ventilated 
rooms, houses the air of which is vitiated by gases from the sewer 
entering through imperfect water closets, or by emanations from a 
privy well, or from decaying vegetables or timber, or by the foul 
odor from pools of waste water or drains, or masses of filth near by, 
and wells of drinking water contaminated by the neighborhood of 
pig-sties, sink drains, and human excrement, are all sources of 



106 Diseases of Adults. 

danger which must be guarded against. It is asserted, also, that 
cast iron stoves, and the hurtful gas which they throw off when 
heated, are answerable for many cases of typhoid fever. Whatever 
lowers the general health and depresses the tone of the nervous 
system, predisposes to the disease. 

Typhus Fever. This disease is also known as ship fever, camp 
fever, jail fever, putrid fever, petechial fever, spotted fever, hospital 
fever, brain fever, bilious fever, and low fever, etc. 

How Brought On. This form of disease, which is essentially a 
disease of the blood, is brought on by the absorption of what is 
known as " crowd poison," which is developed by the exhalations 
from the bodies of many persons congregated together in badly 
ventilated or filthy houses, jails, ships, camps or hospitals. This 
disease prevails almost entirely during the colder portions of the 
year. This is due to the want of thorough ventilation, apt to 
occur in the effort to avoid the cold. It is also extremely liable to 
prevail under all circumstances of privation and misery. It is a 
contagious disease, though very many who are exposed to it do not 
contract the disease. 

How Distinguished. For a few days prior to the full develop- 
ment of the disease premonitory symptoms are observed. There 
are loss of appetite, headache, general weakness or indisposition to 
exertion. The patient then has a chill. Sometimes this is hardly 
noticed, except as a slight feeling of chilliness, or it may be so 
severe as, in rare cases, to cause the death of the patient before he 
can react. This is soon followed by fever, accompanied with a 
rapid, weak pulse, harsh, burning skin, violent pain in the head, 
constipation of the bowels, the tongue covered with a whitish or 
yellowish coat. The hearing soon becomes dull, or even deafness 
ensues ; the mind wanders, particularly at night ; the face becomes 
of a dusky hue. This train of symptoms continues, generally 
growing more profound, the patient lying in a stupor, with more or 
less muttering delirium, but from which he can generally be 
aroused, though speedily relapsing. When this stupor or coma 
becomes very pronounced, it is regarded as a very unfavorable sign. 
The urine is allowed to accumulate, and in som^ cases it is com- 
pletely suppressed. The tongue, which is protruded with difficulty, 



Typhus Fever. 107 

gradually grows darker, even of a blackish hue; hence, the disease 
is sometimes called black tongue fever, or black tongue typhus. As 
this organ becomes dryer, cracks or fissures occur in it, while it and 
the teeth are covered with an accumulation known as sordes. The 
constipation generally continues throughout the attack, and the 
bowels are difficult to move. From the fifth to the seventh day 
the characteristic eruption makes its appearance, although in a 
small minority of cases it is never present. It consists in a rash of 
small, red pimples, on the chest, abdomen and extremities, usually 
appearing in the order named ; first on the chest, then on the abdo- 
men, etc. They are of a mulberry, or measles-like color. At first 
these will almost entirely disappear under pressure, and return as 
the pressure is withdrawn. Accompanying these, on careful 
examination, may be found a number of very small vesicles, known 
as sudamma. Occasionally, rose-red spots are mingled with the 
peculiar eruption. The abundance of the characteristic eruption in 
typhus fever, as a general rule, is a good index of the malignity of 
the attack. There is generally observed a peculiar odor emanating 
from the patient, though this cannot be regarded as special to the 
disease. Bleeding from the nose rarely occurs. As the attack 
proceeds, the symptoms become more marked ; the delirium passes 
almost completely into stupor, the patient lies upon his back in a 
state of great prostration, and often the urine dribbles away invol- 
untarily. 

The duration of the attack is about three weeks, and hence the 
tenth and eleventh days generally form the critical period, from 
which time the decline of the fever and the improvement of the 
patient may be anticipated. Complications may arise, such as 
erysipelas; gangrene, from pressure, particularly of the extremi- 
ties; pneumonia, or inflammation of the lungs, commencing by 
passive congestion, the result of the position of the patient. It is 
rare that a relapse occurs. Occasionally, convalescence commences 
as early as the end of the second week, and may commence sud- 
denly and unexpectedly. Generally, the progress of recovery is 
marked by no untoward event. With the exception of the loss of 
the hair, the health of the patient is, as a rule, better than prior to 
the attack. 



io8 - Diseases of Adults. 

The case may be regarded as tending to a favorable termination 
when the pulse suddenly becomes less frequent and stronger; when 
the patient begins to exert himself, and turns to one side from the 
position oil the back, or draws up one leg, as is naturally done in 
health; when the rash is scanty or absent; when the appetite 
commences to reappear, and the tongue to clean and become moist; 
and when the face assumes a less dusky hue, and the brain is 
aroused to a returning intelligence. 

The usual average of mortality is about one death in ten cases. 

How Treated. As in all forms of severe disease, good nursing 
is a great essential. As to any method of cutting short, or arrest- 
ing this fever, there are no reliable means, though, at various times, 
plans and remedies have been proposed, and even highly lauded, 
but invariably, a full and careful trial has shown their inefficacy'. 
Perhaps the best thing to commence with is a mild purgative, as it 
must be remembered that this is a low form of fever, and will not 
bear any more depletion or weakening of the vital powers. Any 
of the effervescent draughts, in moderate doses, are suitable, 
especially as it is desirable to act by cooling the heated condition 
of the patient. 

From the commencement, there are but few cases which do not 
require, almost from the onset, nourishment in a concentrated form, 
and stimulants. When the heat of the skin is intense, great ameli- 
oration of all the symptoms almost always results from the use of 
cold water. An excellent plan is to sponge the patient all over, 
taking care not to make too great an exposure of the surface. 
Alcohol, or citric acid, or vinegar, may be added to the water with 
advantage. This should be repeated several times daily, the appli- 
cations being governed by the results. Thus, if the patient does 
not feel comfortable after the sponging, but chilliness follows, it 
should not be repeated. But when the temperature is lessened, 
and all the symptoms appear to improve, the indications are that 
the sponging is beneficial, and should be repeated. 

Digitalis and veratrum viride both act well to diminish the force 
and frequency of the pulse, as well as the temperature of the body. 

The best results are claimed for, and would appear to follow, the 
use of the mineral acids, the dilute phosphoric, the sulphuric, the 



Typhus Fever. 109 

hydrochloric, the nitro-muriatie, or the nitric. Of the first, ten 
to fifteen drops are given every hour, or every two hours. As a 
general rule, large doses do not seem requisite, but the acids may 
be given at sufficiently frequent intervals, largely diluted with 
water, and with the addition 'of any pleasant syrup. Few patients 
fail to appreciate this form of medication, and generally relish it. 
The oil of turpentine has long been a favorite form of treatment, 
particularly when the tongue is dry, and the abdomen is swollen by 
the presence of gas. It is best given in mucilage, say, for an adult, 
in fifteen to twenty drop doses, repeated every two, three or four 
hours. 

As this is a zymotic disease, or one due to a fermenting poison 
in the blood, the sulphites have been supposed to be eminently 
applicable as a curative agent. The carbolic acid also has its 
advocates, but neither have yet been proven as possessing great 
value. 

Special indications must be observed as the disease progresses. 
The headache, especially at the onset, claims attention, and may be 
mitigated, if not entirely relieved, by the application of iGe water, 
vinegar and water, cologne water, alcohol and water, and if neces- 
sary, the cold affusion, or bladder filled with crushed ice, may be 
used, the hair having been closely cut. Sleep is important, and to 
procure this, recourse may be had to full doses of opiates, or per- 
haps, what is much better, of chloral. In this connection, it must 
be remembered, that small doses of narcotics frequently add to the 
excited condition of the brain, while a full dose at once procures 
that relief which is so much needed. This, too, aids in relieving 
the delirium, quieting the incoherent talking, or attempts to leave 
the bed, and thus prevents the consequent exhaustion so liable to 
follow. The bromides, particularly of sodium and potassium, may 
be usefully employed to carry out this indication. 

When nausea or vomiting occur, care must be observed that the 
articles of diet, etc., are given in small quantities. Diarrhoea or 
dysentery must be checked by astringents and opiates, when these 
complications appear likely to add to the exhaustion of the patient. 
As the disease progresses, constipation may be relieved by the use 
of enemas, or very mild laxatives. Care must always be had lest 
10 



1 1 o Diseases of A dtdts. 

urine accumulate in the bladder, and the catheter should be em- 
ployed whenever there is reason to suspect the presence of an undue 
quantity. When there are much swelling and tenderness of the 
abdomen, hot mush and other poultices may be applied, turpentine 
stupes, and turpentine in the form of enemas, and by the mouth, 
may be used. Mechanical compression, as a binder applied ovei 
the abdomen, often affords great comfort. 

Should hemorrhage occur, or sudden, intense pain in the abdo 
men, marking the occurrence of perforation of the bowels, the 
situation becomes extremely grave. The utmost quiet must be 
enjoined. Astringents, as tannic acid, acetate of lead, and the sub- 
sulphate of iron, in union with opiates, may be employed to check 
the hemorrhage ; and these may be given both by the mouth and 
by the rectum ; opiates and chloral in full doses, to procure relief 
of the exhausting agony, and to give rest. 

The use of alcohol as a supporting measure, and of abundance 
of fluid, easily digested food, particularly in a highly concentrated 
form, are essentially necessary, sometimes from the beginning, 
always after the first few days. 

Stimulation must be employed solely with reference to the condi- 
tion of the patient. The pulse is the best guide. When the pulse 
becomes fuller, slower, stronger, the stimulation is doing a good 
work. Under its influence the delirium ceases, the restlessness is 
checked, the skin grows moist, and every symptom assumes a more 
favorable aspect. The reverse of these symptoms shows a necessity 
for a lessened stimulation, or its entire cessation. 

As a tonic, quinine, in two-grain doses, three to four times 
daily, is highly beneficial. 

The diet should consist solely of liquids, as milk — first and best, 
eggs, broths, meat essences, etc. These should be given whether 
desired by the patient or not, and at intervals of two to three 
hours. Too frequent repetitions are hurtful, by loading the 
stomach, and not affording time for rest to the patient. The 
quantity given at once should be determined by the attending cir- 
cumstances, care being had not to risk the production of nausea 
and vomiting by the administration of too large quantities. 
Another point is to see that these articles are alternated, $o as not 



Bilious Remittent Fever. 



Ill 



to tire and disgust the patient by too much sameness, and also, by 
a want of care in their preparation. 

Should the stupor become profound, a blister may be applied to 
the nape of the neck, extending well up over the occiput ; and at 
the same time, revulsion may be induced by sinapisms to the 
extremities. To avoid bed sores, etc., and the induction of pneu- 
monia, or congestion of the lungs, the position of the patient should 
be changed frequently, and the parts properly cleansed. When 
the lung complication ensues, dry-cups and blisters to the chest are 
alone admissible. 

How Prevented. The causes should be avoided by thorough 
ventilation, the prevention of overcrowding, and the proper hygienic 
measures. 

Bilious Remittent Fever. This is also called bilious fever, 
remittent fever, and malarial fever. 

How Brought On. Seen most, if not entirely, in spring and fall, 
and due to malaria arising from marshes, or other stagnant bodies 
of water, or the draining of mill-dams, ponds, etc., or the turning 
up of fresh, uncultivated ground, as in new settlements. 

How Distinguished. This disease is ushered in by general lan- 
guor, and depression of spirits, headache, occasional nausea, and 
coated tongue. Presently a chill occurs ; generally not severe, but 
of an hour or more in duration. These symptoms vary in intensity, 
and are followed by fever, which is marked by the usual hot, dry 
skin; the quick, forcible pulse; flushed face; severe, throbbing 
pain in the head ; more or less inability for mental exertion ; violent 
aching pains in the limbs ; nausea, and vomiting of bilious matters ; 
constipation; thirst, and quick respiration. In the course of ten 
to twenty hours, an abatement of all the symptoms occurs, the 
patient appears to be getting better, sleep occurs, and there is 
moisture of the skin, or even a copious sweating. Still, his condi- 
tion does not become quite normal. The pulse remains rather full 
and frequent, more or less headache, and general pains continue, 
with thirst, and general uneasiness of the stomach. These symp- 
toms continue for a period varying from eight to twenty-four hours, 
when the former state is renewed, and every symptom becomes 
aggravated. The tongue now becomes heavily coated with a yel- 



112 Diseases of Adults. 

lowish matter, and the stomach is so sensitive as to reject almost 
every ingesta. When a passage occurs from the bowels, the dejec- 
tion is loaded with bile, but may be more or less slate-colored. In 
extreme cases, there are delirium, and great restlessness, and the 
skin is deeply tinged of a yellow hue. This appearance, however, 
is present, more or less, in nearly every case. 

As the attack progresses, the remissions become more irregular, 
and less marked, and finally, unless checked, the fever becomes 
continuous. 

The duration of the attack varies, according to its violence, from 
six days to as many weeks. Occasionally, a complete intermission 
occurs at the end of the first week, which terminates the disease. 
It is liable to complication by an attack of inflammation of the 
lungs, producing pneumonia; of the brain; of the stomach or 
bowels, when diarrhoea or dysentery follow. As a result of a 
chronic attack, we may have inflammation of the spleen or liver. 
Or, particularly in some abnormal constitutions, or under adverse 
circumstances, as privation or misery, the disease assumes the 
typhoid form. This may occur from neglect or want of proper 
treatment, or the epidemic influence of typhoid fever. The symp- 
toms then, more or less nearly, resemble those of typhoid. The 
pulse becomes high, rapid, 120 to 140 in the minute, and weak; 
the skin harsh and dry; the face assumes a dusky hue; the bowels 
may either be obstinately costive, or affected by diarrhoea; delirium 
and restlessness occur; the tongue is dry and fissured, and covered 
with dark sordes; the weakness is marked, and may be alarmingly 
increased by the occurrence of hemorrhages from the stomach, 
bowels, nose, lungs, etc. Death may at any time close the scene. 
The critical period is often marked by the occurrence of a copious 
perspiration, or of a sudden alvine discharge of black, offensive 
matter, in great abundance. 

How Treated. Active and positive medication are imperatively 
demanded, in order to cut short the attack when possible, and avoid 
the occurrence of the complications and results so liable to follow. 
Bleeding may be regarded as proper when the attack occurs in one 
of a robust nature, where the headache is intense, the pulse bound- 
ing and full, and there is every evidence of a plethoric condition. 



Bilious Remittent Fever. 1 1 3 

Generally, however, the fever may be moderated by a free, active 
purgative, and this should be of a saline character, preceded, if 
necessary, by blue pill or calomel. Care should be taken when 
there is nausea, lest these articles increase the trouble, and result in 
an attack of obstinate vomiting. To meet this indication, an effer- 
vescent, as the citrate of magnesia, will mostly act well, or Seidlitz 
powders, or Epsom salts. 

Refrigerant diaphoretics or effervescent draughts may be given, 
and if the headache is intense, cups, or even leeches, should be 
applied to the back of the neck. If the nausea is very annoying, 
the irritability of the stomach may be controlled by cups or mus- 
tard over the stomach, hot mustard foot baths, and lime water 
and aromatic spirits of ammonia internally. Ice may be given 
freely, and when the stomach is quieted, cold drinks may be freely 
employed. 

Having obtained a remission, more or less complete, that is, a 
decided lowering of the pulse, diminished heat generally, free action 
of the bowels, etc., quinine may be administered. Small and 
frequently repeated doses are best, unless the remission amounts 
almost to an intermission, or where there is reason to fear a return 
of the symptoms in increased force, like a congestive chill, then one 
large dose may be justifiable. If, under these repeated doses, say 
one or two grains every two or three hours, all the symptoms con- 
tinue to improve, the remedy may be continued, and on the occasion 
of the next remission the dose may be doubled, say two grains 
every hour; of course, not necessarily arousing the patient from 



Large, and even enormous doses are indicated when the symp- 
toms assume a grave or malignant form, with great debility. 

As the convalescence progresses, the dose may be gradually 
lessened, say two grains three or four times a day, and this may be 
continued as a tonic until the recovery is complete. 

Complications which may arise will require the usual treatment 
as indicated. 

Where the patient progresses too slowly, and there still remains 
great derangement of the digestive apparatus, and general sallow- 
ness, small doses of some liver tonic, as blue mass, may be used. 
10* 



1 14 Diseases of Adults. 

If signs of thinness of the blood are present, some form of iron 
may be added to the quinine. 

How Prevented. The disease can only be guarded against by 
the avoidance of exposure to malarial influence, though it seems at 
certain times to prevail epidemically, and to attack many who can- 
not trace any exposure to marshes, etc. 

Chills and Fever. This disease is known also as intermittent 
fever, ague, malarial fever, paludal fever, marsh fever, swamp fever, 
littoral fever, chills, shakes, etc. 

How Brought On. This disease is caused by exposure to mala- 
rious influence, as the air of swamps, marshes, bodies of stagnant 
water, etc. 

How Distinguislied. This disease is readily recognized by its 
three stages, which are usually well marked and distinct. First, the 
cold stage, when the patient has a chill of greater or less severity, 
beginning with general uneasiness, yawning, languor, chilliness, 
finally culminating in a chill, or rigor, or shake. The skin is cold 
and blue, the teeth chatter, the patient shakes all over, and com- 
plains of the great coldness, even when loaded with clothing and 
placed close to a hot fire. Along with this he has headache, de- 
pressed spirits, thirst, sometimes nausea and vomiting. This may 
continue from a few minutes to several hours, but the usual average 
is about one hour or less. This passes, gradually, into the second 
or hot stage: The circulation becomes more and more rapid, the 
face is flushed, the skin becomes hot and dry, violent headache sets 
in, the bowels are constipated, the mouth and tongue are dry, and 
the thirst is great. The appetite is lost, and occasionally vomiting 
adds to the trouble. This may last from one hour to twenty; 
generally, at the end of six or eight hours, the patient gradually 
passes into the third or sweating stage. Moisture breaks out on 
the face and upper portions of the body, and extends to the abdo- 
men and limbs, and generally becomes quite profuse. The nausea 
and headache disappear, and the patient, exhausted and relieved, 
falls into a refreshing slumber. 

This is the usual course of an intermittent ; but the order of the 
stages may be reversed, or any of them may be wanting. In place 
of the chill, a neuralgic pain may occur, generally over the brow, 



Chills and Fever. 1 1 5 

or, the chill being absent, it becomes what is popularly known as 
"dumb ague." Sometimes very singular forms present; thus, the 
whole disease may be limited to one-half the body, or to one limb, 
while the rest of the body appears in perfect health. There may 
be dysentery or other diseases complicating the attack, and which 
are completely intermittent. During the intermission the only 
symptom of disorder is more or less debility, with indigestion or 
headache. These intervals occur almost always in the daytime, 
and may extend over more than one day. Hence, the disease is 
known as quotidian, with a daily paroxysm ; tertian, with a parox- 
ysm every other day, etc. The paroxysms have been separated by 
an interval of a week. Again, the case may be a double quotidian, 
that is, with two paroxysms daily. If protracted, as by neglect, 
general debility ensues, with want of red blood, enlargement of the 
spleen and liver, and general dropsy may set in. 

How Treated. When the chill is on, the system may be aided 
to react, by heat externally, and hot drinks freely taken. The 
fever may be moderated by the usual refrigerant diaphoretics, pur- 
gatives to relieve constipation, and cold, acid drinks. 

As soon as the fever ceases, the patient must be placed under the 
influence of quinine, to prevent a return of the paroxysm. One 
or two grains every hour, being careful to give enough to obtain its 
full effects, will generally break up the periodical tendency. At 
least 15 or 20 grains will be necessary. The return once broken, 
it is safest to continue this remedy in smaller doses for several days, 
or a week, at least. There is a remarkable tendency for the parox- 
ysm to return in seven days, or multiples thereof. Hence, prior 
to the seventh day, a large dose, as 10 or 12 grains, should be 
taken. In very obstinate cases, complete recovery may be insured 
by a careful observance of each seventh day, and a renewal of the 
dose in anticipation of each. The cinchona bark, or the other 
extracts from it, as quinidia, cinchonidia, sulphate of cinchona, 
have all been of value, but the quinine is preferable, as most 
certain. 

To break or prevent the chill, opium or laudanum, in one full 
dose, has often proven successful. Chloroform, in one full dose, say 



n6 Diseases of Adults. 

one drachm, mixed with mucilage of gum arable, has frequently 
aborted a chill, and prevented a return. 

Various barks, particularly the dogwood; pepper, or piperin; 
willow bark, and salicin, an extract from it; sulphate of copper; 
arsenic; in fact, a vast number of extremely diverse articles, have 
been greatly extolled as useful in interrupting the tendency to 
return. Perhaps arsenic has best shown this power, but, after all, 
unless the preparations from the cinchona or Peruvian bark cannot 
be obtained, or for some reason are inadmissible, there can be but 
little advantage in resorting to these substitutes. Chills have been, 
broken, and their return prevented, by fright, or some powerful 
impression made upon the person. Hence the success of certain 
charms and incantations, a blister, a shower bath, etc. 

Should the disease be of long duration, a strong tendency to 
relapse is observed, the patient becomes debilitated, and iron with 
quinine may become necessary. 

How 1'rcvented. By avoiding exposure to the causes. 

Break- Bone Fever. This is called Dengue, dandy fever, and 
by some it has been regarded as a form of scarlet fever, and called 
rheumatic scarlatina. 

How Brought On. No cause save epidemic influence has yet 
been assigned to this disease. 

How Distinguished. This disease is ushered in by languor, 
chilliness, pains in the bones and back, headache, fever, and swell- 
ing of the joints. The pains in the bones give rise to the name, 
as many patients express their feeling as if the bones had been 
broken, they "ache in every joint." Dandy fever is supposed to 
be a corruption of Dengue, or an allusion to the movements of the 
patient, whose aches cause him to move with a certain air of stiff- 
ness, like a dandy. By the close of the second or third day the 
fever abates, and the pains diminish. A rash breaks out over the 
whole body toward the sixth day, or even earlier, which is red and 
fine, like that of scarlet-fever ; sometimes more like measles. It 
may vary greatly in its appearance, and be mixed with erysipelas, 
and purpura. Though the patient may be much improved by the 
abatement of the fever, yet generally about the fifth day it returns, 
with a renewal of all the symptoms. After the eruption appears, 



Catarrhal Fever. Wj 

the symptoms seem greatly relieved, and the complaint gradually 
disappears, leaving the patient stiff and sore, with general debility 
for a variable period. In many instances, at the height of the 
attack, there is intolerance of light, restlessness, red and watery 
eyes, swellings of the lymphatic glands, of the neck, arm pits and 
groins, a coated tongue, and tenderness over the stomach. 

How Treated. As the disease must run its course, the treat- 
ment will consist in careful nursing, the relief of constipation, miti- 
gation of the pains by opiates, and anodynes locally ; bathing the 
parts, especially the swollen joints and glands, with laudanum, chlo- 
ral solution, etc. Rest should always be procured by opium, chloral, 
or bromide of potassium. Rubefacients to the spine have been of 
service. After the disease has subsided, tonics may be necessary. 
This disease has rarely been known to result fatally. It is some- 
times followed by rheumatism of the joints, abscesses, boils, etc. 
Hemorrhage may occur from the nose, mouth, bowels, or other 
mucous surfaces. 

How Prevented. As it attacks nearly every one in the locality 
where it is epidemic, removal is the only means of prevention. 

Catarrhal Fever. This is known as epidemic catarrh, influ- 
enza, la grippe, and epidemic bronchitis. 

How Brought On. It is wholly due to an epidemic influence. 

How Distinguished. The patient complains of having taken 
cold; is suddenly and often alarmingly prostrated; has more or 
less running from the nose, red, watery eyes, little cough, headache, 
especially of the frontal region, loss of appetite, more or less chilli- 
ness, followed by fever. Perspiration ensues, drenching the patient ; 
and these phenomena alternate during the attack, which may last 
from three to six days. 

Complications are extremely liable to arise, such as chronic bron- 
chitis, and pneumonia, especially in the aged. The fatality is not 
great, and is generally the result of the pneumonia or other compli- 
cation. It rarely proves fatal, except in the old or those previously 
debilitated. 

How Treated. As this is a fever of great debility, depletion 
very rarely is necessary in any form. With young, plethoric per- 
sons, a brisk purge at the outset, the best the citrate of magnesia, 



1 1 8 Diseases of Adults. 

or some similar effervescent aperient, is beneficial Refrigerant 
diapheretics, hot acid drinks, mustard foot-baths at night," with 
care and protection from the weather, will form the whole line of 
treatment. If there are great restlessness, or want of sleep at 
night, opiates or the bromides will be useful. Tonics, especially 
quinine, or even stimulants, should be employed according to the 
indications. It is claimed that cases may be cut short by the em- 
ployment of quinine at the outset, in full doses, say five grains 
repeated every 4 or 5 hours. Complications, as they arise, must be 
met with appropriate remedies. 

How Prevented. It would appear that no plan can avail to pre- 
vent an attack of this disease, as those who are attacked and those 
who escape are generally occupying the same locality, equally 
exposed, under the same circumstances, etc. Privation and misery 
can scarcely be said to predispose to it, as an equal number suffer 
from it who are in every way comfortably housed, clothed, and fed. 
Of course, these latter influences favor a light attack and a more 
speedy recovery. 

Yellow Fever. This is known as typhus icterodes, American 
typhus, black vomit, el vomito, yellow jack, malignant typhus fever, 
malignant bilious fever, etc. 

How Brought On. This is a disease resulting from blood poison 
generated by peculiar conditions of the locality in whicli it prevails. 
It is not regarded by the best observers to be contagious, yet its 
germs are highly capable of being transported from place to place, 
as in the hold of a vessel, and when these germs are brought to a 
locality where the surroundings favorable to its spread are found, it 
rapidly enlarges its circle and increases the number of its victims. 
It cannot be believed that it can be carried by the sick, as too 
many instances have been known where such have been removed 
from place to place, and yet no new cases have occurred in those 
localities. Again, comparatively few of those brought in contact 
with the sick are found to be attacked, such as physicians, nurses, 
other sick in the same hospital or house. It may prevail as an 
epidemic or by single cases in certain localities. 

The conditions for its rise and spread are a continued high tem- 
perature for several weeks, say above 80° F.; a high degree of 



Yellow Fever. 119 

moisture in the air ; that is, dry, sultry weather for some time ; 
decaying animal or vegetable matter, particularly the latter. While 
it is slow of transportation, yet under favorable circumstances it 
may be spread very rapidly, as though the germs ran riot and grew 
with great luxuriance in a suitable soil. Thus, it has been known 
to be brought to a locality by a ship, but has failed to extend be- 
yond that ship, for want of its proper food on which to grow. 

While there have been many contrary opinions held relative to 
this disease, it is believed the above points are regarded as accepted 
by all calm and dispassionate observers. 

How Distinguished. It generally commences rather abruptly, 
the patient rarely exhibiting any premonitory symptoms, often 
appearing in the best of health and spirits immediately preceding 
the attack. There may be a slight chill or cold stage, soon followed 
by pains in the back and limbs, almost invariably commencing in 
the night, the patient being roused from sleep by the attack. Some, 
however, may experience the usual languor, loss of appetite, slight 
headache and chilliness, which precede almost any form of fever, 
for two or three days prior to the attack. The fever soon comes 
on, and varies in degree, sometimes of great severity, but generally 
moderate, with but slight increase of heat, and a pulse ranging 
about 100. There is moisture of the tongue, with more or less 
coating. Nausea and vomiting may occur, but generally this is a 
symptom which is of later appearance. There is more or less ten- 
derness over the stomach when pressure is made, and constipation 
is nearly always observed. Violent headache, especially over the 
eyes, is a marked symptom. The pains in the back and limbs con- 
tinue, and are very prominent. A point often insisted on as pecu- 
liarly indicative of this disease is the redness of the eyes, called by 
some a " pink eye." In addition, these organs are irritable and 
watery. The mind is generally unaflected, though delirium does 
occur in a sub-acute form The fever continues from a few hours 
to three days, without remission. When it ceases the intermission 
is complete, and often it does not return, and convalescence com- 
mences, with rapid recovery There are generally, however, a cer- 
tain amount of tenderness over the stomach, and a yellowness suc- 
ceeding the flush of the skin. 



1 20 Diseases of Adults. 

In very many instances, after an interval of a few hours, or even 
thirty hours or more, a renewal occurs. The pulse falls far below 
the normal condition, it is weak, thread-like, and in every. way is 
shown a depressed state of the circulatory system. The fever is 
not renewed, for the entire surface remains cool. The debility is 
intense, the tongue is brown, and the stomach becomes irritable, 
and now occurs the peculiar symptom which has given one name to 
this disease; there is a vomiting — sometimes it appears merely a 
reguigitation — of a peculiar black, coffee-grounds matter, mixed with 
a liquid, thin, varying in color, reddish, brownish, or blackish. 
Hemorrhage may now occur from any or all of the mucous sur- 
faces, as observed in all malignant forms of disease. Generally the 
patient complains of this vomited matter, as having an acid taste ; 
occasionally it is terribly acrid, and excoriates the surfaces over 
which it fluws. It is bilious matter mixed with blood more or less 
disintegrated. It differs also in quantity, 'sometimes being in great 
abundance, and again barely perceptible. In addition, the bowels 
discharge quantities of a brownish or blackish matter, like tar or 
molasses. In grave cases, a low muttering delirium now sets in, 
there is a profuse clammy sweat, in short, all the symptoms of 
approaching dissolution, and death closes the scene from the fourth 
to the sixth day. In all cases the yellowness of the skin is marked. 

There has been observed a great variety of difference in all these 
s-nnptoms. Thus, while the prostration is generally great, in some 
instances the patient has been known to continue active to the last, 
and would not acknowledge himself as dangerously ill. These are 
familiarly known as " walking cases." Some show a delirium of a 
decidedly mirthful or cheerful form, even after the black vomit has 
made its appearance. The second stage may vary from ten hours 
to four days. The third stage is one of exhaustion from the poison 
of the disease, as shown by all the symptoms, great weakness, feeble 
circulation, coldness of the surface and extremities, low delirium, 
or apathetic indifference. In place of this latter, we may have 
convulsions, or coma, great distress and restlessness. In non-fatal 
cases, convalescence ensues as the third stage, but recovery has 
occurred even after all these grave symptoms have been present. 






Yellow Fever. 121 

Here, the progress toward health is very slow, with great tendency 
to relapses. 

The average duration of the whole attack is under one week. 

The patient may react from the collapse, and proceed through a 
typhoid condition to convalescence, or which may end in the final 
exhaustion of the patient. The mortality is very great, averag- 
ing two deaths for every five persons attacked. 

How Treated. Perhaps no disease has been so thoroughly 
watched and studied, with so little result as to positive treatment. 
No special mode seems to offer any satisfactory results. To cut it 
short, a great variety of remedies have been employed and lauded, 
but have invariably failed when fully tested. Mild cases tend to 
recovery, regardless of treatment. As debility in grave cases is so 
marked, depressing or depleting treatment must be avoided. For 
the relief of the tenderness over the stomach, and the intense head- 
ache, cups or even leeches have often proved useful to these locali- 
ties. A number of observers agree in recommending the use of a 
purgative dose of calomel, about five grains, followed by an effer- 
vescent or saline, as the citrate of magnesia, a seidlitz powder, etc. 
The use of cinchona or some of its preparations, particularly qui- 
nine, has been strongly recommended, and, in fact, has been employed 
everywhere, and in nearly every epidemic. As a means of aborting 
or cutting short the disease, it has always failed, and hence can 
scarcely be of service in the early stages ; but later, when debility 
is evident, as a tonic it may prove useful, but only in the ordinary 
dose of one or two grains every hour or two. Ice is always a 
necessity, and should be given freely. It is best used when broken 
in small pieces, and allowed to dissolve in the mouth. To aid in 
relieving thirst, and checking nausea and the irritability of the 
stomach, lime water, champagne iced, mineral water, lemonade, 
orangeade, lime juice, or an acid drink made of dilute sulphuric 
acid, will always prove of great value. Each of these should be 
allowed freely, but in small quantities at a time. Charcoal water, 
hot lemonade, and hot coffee have also been of service in checking 
the vomiting. Of course, as before, these should be given in small 
quantities frequently repeated, and as hot as can be borne. A fur- 
ther aid is the use of a mustard plaster or the well known spice 
11 



122 Diseases of Adults. 

plaster over the stomach, and when these fail, a blister dressed with 
morphia may check the irritation of that region. 

To relieve the harsh feeling incident to the hot stage, the whole 
surface may be carefully sponged with cold water. Too much sur- 
face should not he exposed at once, and often this method will pro- 
duce a free perspiration, which is eminently advantageous. 

On the other hand, some propose and claim to have obtained 
great benefit from hot baths. Again, tepid water has been employed 
for sponging, and with apparent good results. Perhaps the best 
guide is the patient's feeling after the sponging. When he finds 
himself comfortable, refreshed, and relieved, the remedy has been 
useful, and may be repeated if necessary. But, when he is left 
chilled, depressed, and decidedly uncomfortable, the remedy has 
not been appropriate. When the stage of collapse comes on, stimu- 
lants become necessary, and must be employed, according to the 
indications; these, and concentrated food, as beef essence, milk, 
etc., must be given in small quantities, frequently repeated, great 
care being taken lest all is lost by the induction of exhausting 
vomiting, and the consequent rejection of everything carried into 
the stomach. In this case, or sometimes preferably, food and 
stimulants may be thrown into the rectum, and will aid materi- 
ally in preventing fatal exhaustion. In all cases, however mild, 
great quiet, cleanliness, and good ventilation must be imperatively 
insisted upon. 

Cases which appear of the mildest form at the beginning, often 
assume a malignant type ; additional means may be employed as 
complications, or rather fresh symptoms, arise. For the extreme 
nausea, and tenderness over the stomach, in some instances, chloro- 
form, creasote, carbolic acid, prussic acid, have been successfully 
emplo) r ed. Astringents have seemed to check the black vomit, and 
among these may be mentioned acetate of lead, the subsulphate, 
the pernitrate, and the chloride of iron. These also are specially 
indicated in the occurrence of hemorrhage. Inquietude, morbid 
vigilance, call for opiates, the bromides, or chloral, and other ano- 
dynes. 

Various antiseptics have been suggested, and in some instances 
are claimed as useful. Among these are the sulphites, carbolic 



Small-Pox. 123 

acid, chlorine, particularly the latter in the form of the chlorine 
mixture, as proposed by Prof. Watson for other analogous affec- 
tions. This is prepared by placing eight grains of the chlorate of 
potassa in a pint bottle, and pouring over the salt one drachm of 
the strong hydrochloric acid. The mouth of the vessel must be 
closed until the reaction ceases, and then an ounce of water added 
and the whole well shaken ; add the water, ounce by ounce, until 
the bottle is filled. The dose of this is a tablespoonful or more, 
according to the age of the patient, and repeated at short intervals, 
so that the whole pint may be taken in one day. 

How Prevented. To prevent the formation or spread of this 
disease, the utmost vigilance is required. The most complete sani- 
tary measures should be taken. Everything calculated to aid it, 
or to act as a nest for its germs, must be thoroughly eradicated. 
Cleanliness, the avoidance of overcrowding, disinfectants for all sus- 
picious localities, the fullest ventilation, will act most efficiently. 
When the disease has attacked a locality, its inhabitants should be 
scattered at once ; the germs should be destroyed by the free use of 
disinfectants, etc., preferably superheated steam, or dry heat. Cold, 
too, destroys these germs, and the reduction of the temperature of 
an infected vessel, etc., below the freezing point, will effectually pre- 
vent the spread of the disease. 

The most rigid inspection of all suspected vessels, as they arrive 
at a locality, will most certainly prevent the introduction of the 



Small -Pox. This disease is known by the name of variola; a 
milder form varioloid; the confluent form is often .called black 
small-pox. 

How Brought On. This disease is solely due to contagion. 
Perhaps no form of disease is so readily conveyed by contagion. 
While it is believed that the fomites must be conveyed by contact 
or a near approach to the seat of the disease, instances are con- 
stantly occurring where the occurrence of the disease cannot be 
attributed to anything else than the epidemic influence. Generally, 
one attack secures an immunity from the disease, but cases do 
occur where the second, or even third attack has been seen. Occa- 
sionally, while a second attack is less grave, now and then, the 



124 Diseases of A dults. 

second time it will assume a malignant form. It would appear as 
though this were due to some vice in the system, or, perhaps, an 
exposure to a very concentrated form of the poison. Filth, want 
of ventilation, privation, and misery, would all, seemingly, predis- 
pose to severe attacks, though, too frequently, the reverse obtains, 
and a malignant type will invade the homes of the most refined 
and luxurious. 

How Distinguished. The earliest symptoms are those incident 
to nearly all fevers, languor, nausea, pains in the head, back, and 
limbs, the pain in the small of the back being, in nearly every case, 
a marked symptom. Chills, and feverish flushes may alternate 
until the fever sets in, which is the primary fever, or fever of erup- 
tion. Along with these, there is, usually, more or less perspiration, 
nausea, vomiting, coated tongue, pain and tenderness on pressure, 
over the stomach, generally constipation, rarely diarrhoea, often 
slight delirium. Pains in the loins is often a special symptom, and 
more or less debility. When an epidemic of this disease is present, 
the disease may be anticipated with great certainty, in all cases 
where great complaint is made of pains in the loins, the small of 
the back, and intense headache. Occasionally, the symptoms are 
very extreme, the fever high, and the delirium great; and convul- 
sions sometimes ensue, or even usher in the attack. Nor is this 
always a criterion of the gravity of the case, as in many cases 
these symptoms speedily vanish as the eruption appears, and the 
disease runs a mild course to its termination. Generally, however, 
the variety known as the confluent form may be anticipated when 
the chill, etc., are marked, and great fever results. 

This stage generally lasts two days, and on the third day the 
eruption begins to make its appearance. In rare instances, the 
eruption is delayed, even to the fifth day, or may not appear at all, 
which is often observed when the disease is epidemic; many per- 
sons who have been exposed will have the fever of small-pox well 
marked, but not followed by any eruption. When it appears very 
early, as the second day, it is more apt to be in the confluent form, 
that is, where the pustules are close or large, and run into each 
other. The discrete, or separate variety, generally may be expected 
when the eruption is slow to appear. Along with the peculiar 



Small- Pox. 125 

eruption, in many cases, there is a rash, or efflorescence, resembling 
that seen in scarlet fever, and frequently this leads to an error as 
to what disease is under treatment, or it is believed to be a mix- 
ture of the two diseases. As in nearly all cases of fever, the 
sudamina, or sweat vesicles, are generally present, particularly on 
the chest and abdomen. This efflorescence may make its appear- 
ance first, and as the small-pox eruption appears, the other fades 
away. In grave cases, or those liable to become malignant, another 
eruption appears, known as petechiae, or ecchymoses, that is, blood 
effused under the skin, in small patches or blotches. When small, 
and limited in number, these are not so very significant, though 
they show a broken down condition of the blood, but when large, 
or very numerous, they are a very unfavorable sign, and are 
extremely liable to be the forerunners of alarming hemorrhages. 
The eruption proper of the disease appears, as a rule, first on the 
face, neck, and wrists, the exposed portions of the body, next on 
the chest and arms, then they extend over the whole body, and 
lastly, on the lower extremities. This takes about three days. The 
first appearance is a small, red spot, slightly raised above the sur- 
face; sometimes these are livid or purplish. Gradually, it rises 
and forms a vesicle, then a pustule filled with a whitish-yellow 
fluid, and with the centre of the pustule depressed, forming a ring 
of fluid. This is the characteristic form, but not all of the pustules 
are thus depressed, or umbilicated. At first, the eruption maybe 
taken for that of measles, but the pimples are smaller, rounder, and 
harder, than those of measles. They give to the touch a feeling as 
of a small, hard body, just beneath the skin. It occupies about 
five or six days for the eruption' to be completed, and to fill up. 
This is the separate or discrete form, but in the confluent form, as 
they fill, the vesicles run together, and form large sacs, as it were, 
filled with the peculiar fluid. In this form a redness over the skin 
is mostly seen, prior to the appearance of the pustules. After the 
sixth day the centre disappears, the fluid assumes a darker color ; 
this is called the stage of suppuration, for the fluid is pus or matter, 
and gives rise to other symptoms. The eruption is not confined to 
the skin, but is found in the mouth, the throat, within the nostrils, 
even on the balls of the eyes, which often cause ulcers and irrepar- 
11* 



1 26 Diseases of Adults. 

able injury to the sight. No doubt the eruption occurs, also, down 
the bronchial tubes to a certain extent, and along the oesophagus. 
Laryngitis, or inflammation of the larynx, has been often caused by 
the eruption, and resulted fatally. 

As the eruption appears, the fever and accompanying symptoms 
generally disappear, or are decidedly lessened, although the fever 
and delirium may continue for a time, and especially is this the 
case in the confluent form. When the suppuration commences, 
say about the sixth day, the fever returns, and is known as the 
secondary fever. Now, the perspirations do not appear as before, 
but the skin is dry and harsh. This fever continues in proportion 
to the gravity of the disease, in mild cases, for three or four days ; 
in the more severe or confluent, much longer. At this time the 
patient is very uncomfortable ; the face, hands, and feet are much 
swollen ; the eyelids often are closed completely ; there is redness in 
all the spaces between the pustules, which is generally accompanied 
with a burning pain. This swelling is regarded as a favorable 
symptom, and when it does not occur in the confluent form, is apt 
to be followed by death. Salivation often occurs, and even to a 
profuse degree, with great swelling of all the glands of the jaw. 
This is so marked, that patients often insist that medicine has been 
given them to cause salivation. At this period, the delirium again 
occurs, especially in severe attacks, and may become maniacal, but 
is generally of a low, muttering form. If, in addition to this, there 
are twitchings, known as subsultus tendinum, coma, diarrhoea, the 
situation becomes one of great danger or vigilance. This stage 
commonly lasts for four or five days. 

About the twelfth or thirteenth day from the inception of the 
attack, the third or dying stage commences, the stage of desiccation. 
The swelling and redness diminish, the pustules break, and the 
contained fluid exudes and forms a thick, disgusting, brown or 
blackish scab or crust. When the pustules are close, these scabs 
unite and form large crusts, glueing up the eyes, the nostrils, cover- 
ing the face like a mask, and giving forth from the whole body a 
most intensely disagreeable odor. This smell is peculiar, and char- 
acteristic of the disease. Once recognized, it is always known as 
the odor of small-pox. The drying of the pustules occurs in the 



Small-Pox. 127 

same order as their appearance, and occupies about four or five 
days. Iu mild cases, the patient now is convalescent, and rapidly 
improves. Gradually the crusts fall off, leaving beneath a discol- 
oration of the skin, which is slow to disappear. These are 
specially observable in cold weather, and in persons of dark com- 
plexion. If the scabs are forcibly removed, and in severe cases, 
they are renewed again and again, and may lead to ulcerations diffi- 
cult to heal. There is more or less pitting left to mark the site of 
each pustule. In the mild cases these soon disappear, but the " pock 
marks" remain as cicatrices, in nearly every case, for a length of 
time. 

In the course of an attack, the patient is liable to a variety of 
complications, as inflammation of the larynx and pharynx, bron- 
chitis, pneumonia, pleurisy, etc. Erysipelas occasionally occurs 
with the eruption. Boils and abscesses very often follow its disap- 
pearance, and greatly prolong the period of recovery. Sloughing 
or mortification has been observed, especially on those parts much 
pressed upon. Inflammation of the eyes may result, and produce 
more or less impairment of vision. The same may occur by exten- 
sion of the disease to the inner ear, and cause deafness. 

In all cases, the occurrence of hemorrhage, bloody urine, and 
petechias, are very alarming symptoms. It is believed that, in the 
confluent cases, the matter, or pus, is often carried into the circula- 
tion, causing pyaemia, or blood poisoning. Since the knowledge of 
vaccination, much of the mortality of this disease is lessened, and 
unless complicated or malignant, nearly all recover under proper 
care and treatment. 

How Treated. As the disease cannot be cut short, the sole 
effort of the physician must be directed to the mitigation of the 
symptoms, and the prevention of complications. Therefore, he 
must watch the progress, and meet everything as it arises. The 
bowels should be unloaded, but not too freely purged. The fever 
may be lessened by the usual remedies — cool acid drinks ; sponging 
the surface with cold or tepid water, as found most grateful to the 
patient ; refrigerant diaphoretics, or the solution of acetate of am- 
monia, or the citrate of potassa; the usual methods of relieving 
nausea, etc. Perhaps for this latter indication, the carbonic acid 



128 Diseases of Adults. 

water now obtainable in syphons, at the shops, will prore best ; it 
rarely fails to quiet all irritability of the stomach. A number of 
observers have employed articles with a view of lessening the 
amount of matter, or pus formed, and for this purpose have sug- 
gested the free use of the sulphites, or the sulpho-carbolates, in full 
and frequent doses. For this purpose, also, much praise has been 
given to the pitcher plant (Saracenia purpurea), but it has failed 
to yield any advantages, and is now generally abandoned. Of 
course, the utmost attention must be paid to cleanliness, ventilation, 
etc., as in all diseases of this character. To prevent the great 
exhaustion which is generally the cause of death, the diet should 
be supporting from the moment of departure of the first febrile 
symptoms, and the appearance of the eruption. All food should 
be of the concentrated liquid form, soft-boiled eggs, milk, and arti- 
cles made with it, beef tea, mutton and chicken broth. These 
should, at first, be given in small and frequently repeated doses, to 
coax the appetite, and to avoid increasing or bringing back the 
nausea and vomiting. As the powers of digestion improve, and 
the appetite returns, the amounts may be increased. Signs of 
prostration indicate the necessity of stimulants, as wine-whey, milk- 
punch, brandy or whisky and water, quinine, the muriated tinc- 
ture of iron, etc. To relieve the morbid wakefulness, and induce 
refreshing sleep, opiates, the bromides, or chloral may be used. 

A great object is to prevent pitting of the face, which so greatly 
disfigures the individual ; some endeavor to abort the vesicles by 
puncturing them with a fine needle, and emptying the fluid, by 
touching each with a fine point of nitrate of silver ; then to exclude 
air, and soothe the inflammation by covering the whole face with a 
soft poultice of flaxseed, slippery elm, or bread and milk. A 
variety of plans have been proposed to exclude the air, such as cov- 
ering the face with a mask of mercurial ointment, collodion, and 
glycerine, gold leaf, white lead paint, tincture of iodine, subnitrate 
of bismuth and prepared chalk, poultices of various ingredients, 
carbolic acid, gutta percha softened in chloroform. All have been 
highly lauded as successful in a few cases, but none have succeeded 
entirely. Perhaps the best is the careful touching of each pustule 
with the fine point of caustic, followed by any light poultice, and 



Milk Sickness. 1 29 

when the pustules have flattened, cover the entire surface with 
collodion, mixed with a very small proportion of glycerine, to soften 
it. This must be renewed, as it cracks from time to time, until the 
completion of the desquamatory process. 

When the parts are much heated, evaporating lotions should be 
constantly applied. Every effort should be made to prevent the 
pustules forming on the eyeball. For this purpose compresses wet 
with cold water should be constantly applied ; some suggest a weak- 
solution of corrosive sublimate. 

Complications must be appropriately met as they occur. Great 
care is required, in the stage of c<»nvalescence, to avoid exposure of 
the patient to cold or sudden changes of temperature. , The patient 
should be aided to repair the great waste incurred by profuse sup- 
puration, by the long continuance of tonics, especially some form of 
iron, and the best regimen. 

How Prevented. Vaccination is the great preventive of this 
disease. This must be thorough. It has been proposed that after 
a vaccine vesicle has crusted, the patient should be re-vaccinated as 
often as he will take, thus hoping to exhaust the susceptibility of 
his system. Even when vaccination does not prevent the disease, 
it modifies it markedly. Great care should be had to see that the 
vaccination is complete, and not too old. It is safest that this opera- 
tion should be repeated at intervals not to exceed five or six years, 
and always when an epidemic is prevailing. To prevent diffusion 
of the disease, the utmost cleanliness and free ventilation should 
be rigidly enforced. Patients should not be permitted to mingle 
with other people, until the scabs have completely disappeared, and 
only after repeated and thorough bathings. Their clothing must 
be thoroughly disinfected, or better, destroyed ; everything used in 
the sick room should be subjected to a similar treatment. The 
attendants should observe the utmost care, lest they act as trans- 
porters of the germs of contagion. Change of dress, and the most 
thorough washing of the hands, ought to be the very least they 
should do. 

Milk Sickness. This disease has received a variety of names, 
as puking fever, the trembles, swamp sickness, river sickness, the 



130 Diseases of Adults. 

slows, the tires, the stiff joints, etc., all referring to its supposed 
cause or some of its prominent symptoms. 

How Brought On. It is induced by eating the flesh or drink- 
ing the milk of cattle affected with the disease. Cattle are supposed 
to be attacked by it after eating certain weeds found only in pas- 
tures not before cultivated. It is only observed in certain regions, 
and rapidly disappears as the ground is broken up and its cause 
thus destroyed. 

How Distinguished. The symptoms are sick stomach, vomiting, 
purging, great nervous prostration, trembling, stiffness of the joints, 
and a feeling of tiredness, remaining long after the main symptoms 
have disappeared. 

How Treated. The treatment consists in most complete rest, 
emetics and laxatives, if requisite, to cleanse the stomach and bowels 
from the poisonous matter, bland fluids, for the thirst, and a diet 
of an appropriate kind. No special mode of treatment has been 
found beneficial. 

How Prevented. By avoiding the use of the milk or flesh of 
animals thus diseased. It is claimed that if the milk is well boiled, 
and the flesh subjected to a high temperature, the source of the 
disease is destroyed, and these articles may be used with impunity. 

The disease is now so rapidly disappearing, that few opportunities 
are obtained for its study, and hence but little can be said concern- 
ing it. 

II. Ailments attended with Pain as the Prominent 
Symptom. 

Neuralgia. This disease is truly a nerve-pain, and may affect 
any portion of the body. From its location it derives a variety of 
names, as hemicrania, when it affects one side or half of the head; 
tic douloureux, when it attacks the face, sometimes called facial 
neuralgia; sciatica, when it affects the great nerve of the hip; 
pleurodynia, attacking the side, or pleura; gastrodynia, the stom- 
ach ; angina pectoris, the heart, etc. 

Hoio Brought On. It' is generally caused by a sudden exposure 
of the part to cold ; an injury of the nerve ; weakness, as want of 



Neuralgia. 131 

red blood; the action of some poisons, as that of lead; or by mala- 
rious influence, when it takes the form of intermittent neuralgia. 

How Distinguished. This form of pain is not associated with 
an inflammation, but seems limited entirely to the particular nerve 
affected. The pain is acute, shooting, sometimes expressed as a 
stabbing pain, with great tenderness on pressure over the affected 
part. Particularly is this shown when the pressure is made with 
the points of the fingers, when the patient will shrink or cry out. 
But if the pressure be more firm, the pain diminishes or disappears 
entirely. The pain is generally intermittent, that is, not always 
recurring at the same time, as in the form of intermittent neuralgia, 
but it comes and goes ; there are paroxysms of acute pain, and in 
the intervals even the tenderness on pressure may disappear. 
Again, certain movements increase it, as a fall, or sudden concussion, 
coughing, laughing, sneezing, the application of cold or heat to the 
seat of the pain. It may, and often does, cause contraction of the 
muscles of the part, cramps, etc. No fever is ever present, though 
neighboring glands may become enlarged and painful. 

How Treated. If the patient is anaemic, that is, wanting red 
blood, the appropriate remedies should be employed. It has been 
forcibly remarked, that "pain is the prayer of the nerve for 
healthy blood." To meet this indication, some form of iron, and 
preferably, the tincture of the chloride of iron, known also as the 
muriated tincture of iron, is best, and most certain to yield good 
results. The pain itself must be relieved, as excess of pain is 
exhausting and demoralizing to the entire system. Opiates in 
sufficient doses, or in the form of hypodermic injection of a solution 
of morphia, will generally relieve the paroxysm. Preferably, how- 
ever, is the use of some article not so liable to lead to subsequent 
bad results, as the opium habit is most frequently formed in the 
effort to obtain relief from pain. Belladonna has proved of great 
value, and may be employed inwardly, and externally as a plaster, 
or in a lotion. This article, combined with morphia, both in full 
doses, has obtained a great reputation for the relief of neuralgia. 
Then we have aconite, hyoscyamus, conium, Indian hemp, chloral, 
etc. Lotions, or local applications, often speedily relieve. Thus, 
the part is commonly bathed, and covered with cloths saturated 



I3 2 Diseases of Adults. 

with equal parts of laudanum and sweet oil, chloroform, liniments 
of belladonna, aconite, etc., ointments of the same, or stramonium, 
veratria, etc. Often, a mustard plaster will give the most prompt 
relief. Even flannels, wrung out of hot water, applied to the part, 
have proved useful. When anodynes are used, a full dose will 
moderate, if not remove, the pain, and the dose should then be 
renewed, at short intervals, and in diminished quantity, until no 
return is observed. 

An immense variety of quite diverse remedies have been pro- 
posed, and lauded as useful, many of which are well worthy a trial. 
Prominent among these is a mixture of equal parts of chloral and 
camphor. When rubbed well together, these form a thick oily 
fluid, which may be applied to the seat of pain, and renewed as 
necessity demands; carbolic acid dissolved in camphorated oil; 
painting with the tincture of aconite ; an ointment of veratria, grains 
twenty, to lard, one ounce. Occasionally, when other means fail, a 
blister over the seat of pain, dressed with morphia, will relieve 
promptly. Perhaps the subcutaneous injection of this drug is the 
most prompt means in severe or obstinate attacks. Anesthetics, 
as chloroform, ether, nitrous oxide or laughing gas, act to relieve 
paroxysms, but some general treatment is required to insure perma- 
nent benefit. Constitutional treatment will consist of quinine, 
especially if malaria is regarded as the cause, iron, strychnia, or the 
nux vomica. These three, in combination, act with great prompt- 
ness. The muriate of ammonia has been recommended, and cer- 
tainly will often prove useful. For special forms of neuralgia, we 
have bisulphide of carbon, applied behind the ear, or to the temple ; 
oil of turpentine; phosphorus, this especially for nervous debility 
as a cause of the pain ; creasote, carbolic acid or crystals of chloral 
to the hollow of a tooth which is the seat of neuralgia, or some 
form of tobacco, oil of cloves, in fact, all these oils ; brandy or 
whisky, which act by stimulating the part above the point where 
pain is felt. 

Full diet, change of air, if possible, sea bathing, act as aids, and 
lead to a permanent cure. Many cases of headache are a species 
of neuralgia, and are relieved by the same treatment, as quinine, 
iron, ete. Recently, we have had the monobromate of camphor, 



Headache. 1 3 S 

the guarana, and the bromide of quinia, greatly lauded in this 
affection. Each case requires a careful study of its causes, and 
their removal, if possible. If there is associated with the headache 
a sick stomach, with acidity, some antacid, as magnesia, particu- 
larly the carbonate, aromatic spirits of ammonia, or if the tongue 
indicate, podophyllin or a blue pill, will give relief, which will often 
be the ending of that attack. In addition, the valerianate of zinc, 
iodide of potassium, especially in a case with rheumatic tendency, 
arsenic, the bromides, the latter in very large doses, have proved 
especially valuable. 

It is not necessary to specify the treatment for each particular 
form of this disease. Local applications, of course, are most useful 
when applied directly over the seat of pain, though hypodermic 
injections will relieve when inserted at any point. 

Headache. This is technically known as cephalalgia. 

Generally it is only a symptom, as showing congestion or fullness of 
the brain, dyspepsia, or some form of disorder of the intestines, etc. 

How Brought On. It may result from rheumatism, neuralgia, 
poisoning, as by alcohol, narcotics, etc., fever, disease of the brain, 
womb disease, constipation of the bowels, overloading of the stom- 
ach, excitement, etc. 

How Distinguished. When it is due to neuralgic trouble, it is 
generally one-sided or partial, as over the brow, and more or less 
intermittent. There is generally pain on pressure of the scalp, etc. 
There is also, in place of a constant pain, a darting or shooting 
pain from temple to temple. When it is the result of rheumatism, 
it is associated with more or less stiffness of the muscles, and rheu- 
matic pain elsewhere. When due to congestion, fever, poison, etc., 
the pain is accompanied with heat and throbbing. A constant 
pain in the top of the head, often expressed by the patient as occu- 
pying a spot the size of a finger nail, may be regarded as caused by 
womb trouble. This form, too, is liable to result from a tumor of 
the brain, or some other disease of that organ, or pressure on the 
brain, from an enlargement or thickening of the skull bones. Head- 
ache due to constipation, is generally a dull heavy pain, with a con- 
fused feeling, increased by every effort, or even by the attempt to 
think or talk, etc 
12 



134 Diseases of Adults. 

How Treated. Firm pressure upon the head, even the tying up 
of the temples with a handkerchief, will often greatly relieve the 
intensity of the pain. Rubbing the scalp often acts in a similar 
way. When there is nausea, and there is reason to believe that 
the pain is the result of overloading the stomach, the presence of 
indigestible matter, or of a poison, as alcohol, opium, etc., an emetic, 
aided in its action by free draughts of warm water, or salt, or mus- 
tard and water, will frequently give immediate relief, which is fol- 
lowed by a refreshing sleep, from which the patient awakes perfectly 
recovered. When the headache seems due to nervous exhaustion, 
as when there is no nausea, it is known as nervous headache, and a 
full dose of aromatic spirits of ammonia, or of the bromides, or of 
the two remedies combined, will generally give prompt and perma- 
nent relief. When the tongue is furred, and the bowels constipated, 
free purgation is indicated, and preferably with blue pill, podo- 
phyllin, or some article which will act readily upon the liver, followed 
by a seidlitz powder, citrate of magnesia, etc. When an attack is 
heralded by premonitory symptoms, as in some cases, it often may 
be warded off by a full dose of some opiate preparation, the carbon- 
ate of ammonia, a free saline purgative, one of the bromides, or 
chloral. During a paroxysm, the anaesthetic influence of ether or 
chloroform, partially induced, evaporating lotions to the head, as 
alcohol, bay rum, cologne water, vinegar, ether, etc., afford great 
relief. Cold or warm water freely applied to the head, according to 
the feelings of the patient, often gives great comfort. A drawing 
of the blood from the head will be effected by hot mustard foot- 
baths. With persons predisposed to headaches, great relief is often 
obtained by a cup of strong tea or coffee. To prevent its return, 
the cause should be removed or avoided, and any condition of the 
system predisposing to it should be corrected. For debility, iron, 
quinine, nux vomica, strychnia, arsenic, and the preparations of zinc. 

How Avoided. By care in hygiene, the avoidance of all causes 
of the disease, the removal of constitutional troubles. When due 
to uterine trouble, this should be carefully inquired into and re- 
moved. Rheumatic tendency may be relieved by iodide of potas- 
sium. That due to alcohol, etc., should be prevented by strict 
abstinence from these articles. 



Rheumatism. 135 

R heumatism . This is divided into acute and chronic ; articular, 
or that affecting the joints and muscles. 

How Brought On. This is the result of exposure to cold, and 
particularly when the hody is in a state of perspiration. The acute 
form seems to attack, almost solely, those of what is called a rheu- 
matic diathesis, or constitutional tendency. The chronic form 
mostly attacks the aged, though it occurs at all ages. Again, it 
may be the result of a blood poison, as that of syphilis or gon- 
orrhoea. 

How Distinguished. The acute form of rheumatism is marked 
by fever of a high grade, accompanied with inflammation of the 
joints, sometimes one or two, again several, or nearly every 
joint will be affected. These parts are swollen, red, hot, and pain- 
ful. Generally the shoulder joints, the elbows, the wrists, and 
ankles, are the parts affected. While the symptoms still continue, 
the parts are often bathed in perspiration. An attack may last for 
months, but generally averages about three weeks. It may result 
in incurable stiffness of one or more joints. 

In frequent instances, this form has had as a sequel chorea, or 
St. Vitus' dance. It is extremely liable to bring on heart disease, 
which is almost never relieved. A singular incident is the sudden 
change or transfer of the disease from its first location to another. 
This is called metastasis, and is a dangerous complication. The 
part affected is suddenly relieved, the symptoms entirely or almost 
disappear, and suddenly they attack a distant joint or part; the 
heart, the brain, the stomach, are all liable, and in such an event, 
the situation becomes extremely grave. 

The chronic form is a slow inflammation of the parts affected, and 
the pains are generally increased at night; there is a vague, tired 
pain of the affected part. 

That resulting from the blood poison, as above mentioned, gene- 
rally affects the long or flat bones, and rarely the joints. Along 
with the pain are found swellings, like lumps on the bones ; these 
are called nodes, and are generally associated with inflammation of 
the membrane which covers the bone, the periosteum. 

How Treated. The acute form requires a constitutional treat- 
ment of an active character. A variety of plans have been pro- 



136 Diseases of Adults. 

posed, with strong advocacy, and many have been abandoned as 
useless. Thus, the treatment by alkalies, as the carbonate or bi- 
carbonate of potassa, in full doses, say twenty to thirty grains three 
times daily; the nitrate of potassa; the acetate of potassa, seems 
to have given most excellent results in very many instances. Sleep 
must be obtained, and the best remedy for this purpose is opium, 
as in the form of Dover's powders, which is a combination of opium, 
ipecacuanha, and sulphate or nitrate of potassa. The bromides or 
chloral, also, are useful to meet this indication. Locally, the pains 
may be relieved by anodyne applications, as laudanum, etc., to the 
affected joints. 

Among the remedies, have been the free use of lemon-juice, qui- 
nine, colchicum, calomel, alone or combined with opium. These 
may be employed according to circumstances. Thus, quinine may 
be used where feebleness is evident, as by the presence of profuse 
perspirations. Lemon-juice may be allowed freely. Colchicum, 
when there is reason to believe in a gouty tendency. This, com- 
bined with an alkali, is a favorite remedy with many. To avoid 
the heart affections, bromide of ammonium has been thought use- 
ful, in fifteen to twenty grain doses. Several observers have found 
good results from repeated small blisters, applied to the affected 
parts. In debilitated cases, the muriated tincture of iron is espe- 
cially valuable. 

In the chronic form, the most useful remedy is the iodide of 
potassium in full and continued doses; guaiacum also has been of 
great value, though objectionable by its extremely unpleasant taste. 
Locally, liniments of various kinds may be useful, as those contain- 
ing laudanum, turpentine, hartshorne, mixed with the soap lini- 
ment or chloroform or aconite liniments. Some have claimed good 
from the use of blisters to the spine, between the shoulders, when the 
pain is in the upper extremities, or over the small of the back when 
in the lower extremities. In the place of these, cups, cut or dry, 
may be employed. Hot water or vapor baths are of great value, 
particularly to relieve stiffness of the joints. Another plan is to 
sweat the affected joint by enveloping it in cotton batting covered 
with oiled silk. In that form due to gonorrhoea or syphilis, the long 
continued use of iodide of potassium is the only means that will 



Gout. 137 

give any relief. The muriate of ammonia and opiates at night have 
also been very valuable. Some practitioners claim the best results, 
in all forms, from full doses of opium or its preparations, on the 
principle that the relief of the pain cures the disease, and certainly 
tbeir reputed success would seem to warrant this belief. Chalky 
deposits in the joints often follow repeated attacks. 

Gout. This is also known as arthritis, or podagra. 

How Brought On. This disease is due to a constitutional tend- 
ency, and is superinduced by excesses in eating and drinking. 

How Distinguished. This is generally preceded, for a few days, 
by symptoms of indigestion, acidity of the stomach, flatulence, cos- 
tiveness, etc. Suddenly, sometimes, even without these symptoms, 
a joint, generally of the great toe, the ankle, the wrist, becomes very 
painful, red, and swollen. The pain is generally intense, and con- 
tinues for several days. Some characterize it as a gnawing at the 
bone, a tearing of the parts asunder, a burning, as by fire. It is 
always accompanied by throbbing, and there is more or less general 
fever and nervous irritability. When these symptoms subside, the 
part is bathed in sweat, and the patient sleeps, from exhaustion. 
The paroxysms return at more or less frequent intervals, and may 
occupy the same or another joint. During a paroxysm, there is 
great danger of metastasis to the heart, or stomach, which may 
speedily end in death. This is known as misplaced or retrocedent 
gout. 

This disease is distinguished from rheumatism, by its location ; 
in the former, the small joints, in the latter, the large ones are at- 
tacked. There is great resemblance, and often the two appear com- 
bined, and this is called rheumatic gout. 

How Treated. During the paroxysm, colchicum and the 
alkalies are most useful. Of the wine of the root or seeds of col- 
chicum, ten to twenty drop doses may be given every three or four 
hours. Added to this, ten to thirty grains of the carbonate of 
potassa, or a full dose of the acetate, will generally promptly give 
relief. Care is requisite at first, not to offend the stomach, and 
cause nausea, and its action on the heart must also be guarded. As 
this disease is liable to be followed by chalky deposits, as in rheuma- 
tism, various remedies have been urged to dissolve these or hinder 
12* 



138 Diseases of Adults. 

their deposition. Lithia, in the form of the citrate or carbonate, 
has been employed, with apparently good results. As the intense 
suffering must be relieved, anodynes, as the opiates, are beneficial. 
Locally, care must be taken lest cold to the parts cause a retroces- 
sion of the disease, and its appearance at a less favorable point. 
Washes containing laudanum, the alkalies, etc., may be applied on 
rags to the part, and then covered with oiled silk. In case of a 
retrocession to the stomach, etc., stimulants, as brandy, laudanum, 
compound spirits of ether, chloroform, chloral, the tincture of rhu- 
barb and senna, may be freely given at short intervals. To repro- 
duce the attack in its original seat, place the feet in hot mustard 
baths ; and also apply mustard to the chest, over the stomach, etc. 

How Prevented. Where the tendency exists, the utmost care 
will be necessary to avoid all excesses ; not by reducing the system 
by too great abstemiousness, but the avoidance of what is known as 
"high living," or excesses of any kind. Full nutrition, by articles 
easy of digestion, exercise in the open air, avoidance of constipa- 
tion, will generally prolong the intervals between the attacks and 
ward off fresh ones. Add to these, in obstinate cases, change of 
air, as by traveling, the use of mineral waters and baths, and all is 
done that can contribute to success in this particular. When the 
system is depressed, iron and bitter tonics are very serviceable, but 
should not be too long continued. 

Lockjaw, or Locked Jaw. This is known also as tetanus, or 
trismus. 

How Brought On. This is generally the result of some injury 
or wound, more particularly what are known as punctured or lacer- 
ated wounds. A clean cut rarely is followed by locked -jaw. It is 
also due to crowding, carelessness as to ventilation and cleanliness, 
in hot climates. Cases are occasionally seen which apparently 
result from cold. That form from wounds, is called traumatic 
tetanus, and the other form is idiopathic. Another form, occurring 
in the newly born infant, soon after delivery, is tetanus of the new 
born, or trismus neonatorum. Sometimes this prevails to a great 
extent, and was formerly extremely common among the plantation 
hands in the Southern States of America. It generally makes its 
appearance within the second week from birth, and results fatally in 



Lockjaw. 1 39 

a very few days. By some, the disease is regarded as allied to 
rheumatism. 

How Distinguished. The attack is ushered in by a feeling of 
Stiffness of the muscles, generally of the jaws, hence the name locked- 
jaw. It speedily extends to the muscles of the throat, the chest, 
and the limbs. The stiffness increases to a spasm, which is parox- 
ysmal, though it never entirely ceases. In severe cases, the spasm 
of the muscles of the spine is so great as to cause an arching back- 
ward of the whole frame, so that the patient lies on the bed sup- 
ported only by the head and heels. Rarely, the reverse obtains, 
and the body is bent forward. Still more rarely, the curvature is 
to one side or the other. The jaw is frequently so tightly closed 
that food cannot be taken, and it may become necessary to knock 
out a tooth in order to open a passage for the articles of nourish- 
ment. When the muscles of the face are attacked, the most horri- 
ble grimaces are produced, or the mouth is drawn back at its angles, 
giving the appearance of an ugly laugh, called the sardonic grin. 
The spasm is often so unexpected that the tongue is caught between 
the teeth and badly bitten. Occasionally it involves the muscles of 
swallowing, and this becomes a matter of impossibility, the patient 
being liable to choke in the act. The breathing is more or less 
impeded by the stiffness of the muscles of the chest, producing 
labored respiration. These spasms are attended with great suffering, 
and are induced by the slightest cause, as a dash of cold water or 
air on the surface, a sudden touch — even a mental effort will cause 
them. Sleep is almost impossible, except from the influence of 
some narcotic. Occasionally, delirium, though not of a high grade, 
occurs. Thirst is usual, though it is really attributable to the diffi- 
culty of swallowing. The mouth generally is filled with foamy 
saliva, streaked with blood from injured parts. The teeth may be 
broken by the force with which they are brought together. The 
bowels are costive, but there may be involuntary passages ; as also, 
the urine may be retained, or pass involuntarily. Death may occur 
suddenly, from asphyxia in a spasm. Though the spasm produces 
an increase of heat of the body, yet there are usually profuse per- 
spirations, both in the spasms and during the intervals. A common 
symptom is a piercing pain at the pit of the stomach, going through 



140 Diseases of Adults. 

to the back. Death follows in from twenty-four hours to as many 
days, generally in ten or twelve days. It is a very fatal disease, 
being slightly less fatal when not due to an injury. 

It may be confounded with strychnia poisoning, from the pres- 
ence of the spasms ; but here the succession of spasms is extremely 
rapid, the lower extremities are most affected, the legs being extended 
and the feet drawn inward, the jaw spasm is much less, and the 
face is rarely affected, the swallowing is easy, only the patient snaps 
like a mad dog at what is offered, and swallows it with a gulp. 
Also, the result is quickly fatal, and there is the history or attend- 
ing circumstances to aid in the diagnosis. 

It may be known from cerebral trouble, or spinal meningitis, by 
the absence of inflammation, of delirium, headache, and coma or 
stupor. From epilepsy it is known by that disease having inter- 
vals of apparent perfect health. Occasionally, there is a slight 
locked-jaw, with hysterical attacks, but the accompanying circum- 
stances will define the disease. 

How Treated. The treatment is generally unsuccessful. An 
infinite variety of remedies and plans have been suggested. Some 
powerful narcotic would seem to offer the only hope of relief. 
Opium, combined with brandy, say a grain every two hours, or 
even every hour, has appeared of value. Or hypodermic injections 
of morphia might be preferable, as more easy of administration, 
and more speedy in results. The utmost quiet must be enforced ; 
light, noise, and draughts of air, must be excluded. As the patient 
will die from exhaustion, unless nourished, some plan must be 
employed to meet this indication. Food is to be given in a concen- 
trated liquid form, and stimulants in full doses. Nutritious and 
stimulating enemas may be thrown into the bowels. In some cases, 
a tube has been passed between the teeth, as in the absence of a 
tooth, and carried into the stomach, by which canal, food, etc., have 
been thrown into that organ. Inhalations of the various anaesthet- 
ics have been very often useless, though they may partially control 
the spasms, and make the patient more comfortable. Among other 
remedies, have been belladonna, Indian hemp, quinine, all in large 
doses; the application of irritants to the spine, ice to the spine, cold 
affusions, etc. Of later years, a variety of new methods have been 



Wakefulness. 141 

suggested, as chloral, nitrite of amyl, croton chloral, the calabar 
bean, woorara, etc. As, in some instances, the remedial applications 
have been carried to excess, it becomes a grave question whether 
some deaths might not be the result of these doses. 

Perhaps the best plan would be the relief of the spasms by some 
article, as chloroform inhalations, or chloral, nutritious alimentation, 
and quiet. Instances are related, where recovery has ensued under 
such treatment. 

How Prevented. The prevention of this disease could only be 
attempted when it was prevailing as an epidemic, among new-born 
children, or when an injury had occurred, and such a result was 
feared. For the first, removal from the locality, cleanliness, and 
care, would be all that could be done. For the latter, care, quiet, 
relief of pain, emollient and soothing applications to the seat of 
injury. Amputation of an injured part has been proposed when 
the nerves of the limb are involved, as the surest method of pre- 
venting the inception of tetanus. 



III. Ailments attended with Sleeplessness as the Promi- 
nent Symptom. 

Wakefulness. Known as insomnia, morbid vigilance. 

How Brought On. This symptom, for it cannot be regarded as 
a disease, marks the presence of some form of disease of the brain ; 
or is the result of strong mental excitement, or mental labor ; or is 
caused by excessive pain, or the inordinate use of articles, as strong 
tea, coffee, tobacco, etc. 

How Distinguished. When not the result of acute pain, the 
patient finds himself, at the hour for retiring, wide awake, and is 
unable by any of his usual methods to compose himself to slumber. 
The history of the case will enable the physician to decide as to 
whether it is the result of excitement, over- work, the use of stimu- 
lants, etc., or a symptom of hidden brain affection. When no 
other cause can be assigned, the gravest fears may be felt lest it re- 
sult in insanity, inflammation of the brain, or softening, etc. 

Hoio Treated. The treatment will depend solely upon the cause. 



142 Diseases of Adults. 

Whatever this may be, it must be removed, if removable. The 
patient should be made fully to understand the danger he is in, and 
to lend his entire concurrence in the efforts for his relief. Mental 
labor should be given up ; overwork of any kind must be abandoned ; 
articles liable to keep up the trouble must be forbidden, such as to- 
bacco, coffee and tea. If general debility be present, the system 
must be brought to a natural standard by tonics and a proper diet. 
If there are symptoms of a fullness of tbe brain, this must be re- 
lieved by cups, or leeches to the nape of the neck, the temples, etc., 
or a blister to the same spot, dressed, when requisite, with morphia. 
Occasionally, this fullness may be relieved by proper physical exer- 
cise, as a long walk, calisthenics, etc. All excitement of any form 
must be avoided just prior to the hour fur sleep, hence, light exer- 
cise at this time will be best, as diverting the attention from busi- 
ness, etc. Instances are common where the patient suffers from an 
empty stomach, and a quantity of easily digested food will satisfy 
the craving and promote a sound, refreshing slumber. Again, 
cold to the head, or hot foot baths, with or without mustard, or a 
warm bath, will relieve the patient promptly. The patient should 
examine his surroundings, as to whether any cause exists, such as 
improper position in bed; the best is always where the head and 
shoulders are above the level. For the relief of this symptom, 
except where it is the result of pain, medicines should be employed 
with caution. It is always best to obtain sleep with the mildest 
means first. A glass of beer at bed-time, a hop pillow, or the pre- 
parations of hops, hyoscyamus, lactucarium, bromide of potassium 
or of sodium, will generally relieve, and preferably in the order 
given. Some observers have found that opium or morphia, added 
to the bromides, appear to correct the unpleasant action of the 
opium, and aid its effects. The best remedy of all is the chloral. 
This should be employed in positive doses, say fifteen or twenty 
grains, repeated, when necessary, in one, two or three hours. A 
variety of other remedies have been proposed, but those quoted will 
answer the purposes. 

Delirium Tremens. Called also mania-a-potu, alcoholism, 
dipsomania, potomania, the horrors. 

How Brought On. It is caused by the abuse of alcohol, and 



Delirium Tremens. 143 

is generally induced by the sudden withdrawal of stimulants, or 
their long-continued excess. 

How Distinguished. The symptoms are want of appetite, wake- 
fulness, trembling of the muscles, debility, loss of digestion, 
unreasonable horror at slight causes, hallucinations. Want of sleep 
is the chief and most important symptom. This relieved, recovery 
rapidly follows. The dreams, for though he is awake, they are 
dreams, are of monsters, enemies, unnatural objects hovering around 
him, and endeavoring to injure or annoy him. Rarely they are of 
an amusing form, or he may perform imaginary tasks, and hold 
conversation with spirits, which he imagines he alone can see. 
Death will result unless relieved by sleep, though instances have 
been known where sleep was not obtained for two weeks. Gener- 
ally, in three or four days, the attack yields, sleep comes on, and he 
awakes cured, though weak. 

How Treated. Upon this point much difference of opinion 
exists, though the disease has been so fully studied, the opportuni- 
ties being, unfortunately, very frequent. Formerly, the plan of 
" tapering off," was regarded as best, and the patient was made to 
gradually abandon his stimulants, while opium or some narcotic was 
given to aid in his relief. But, at present, excellent observers agree 
in ascribing the best results to other plans, in which the stimulants 
are positively forbidden. Perhaps the most positively successful 
plan, is that by giving highly nutritious food, in a concentrated 
form, and procuring sleep by the use of large doses of chloral. In 
a number of instances this has proved highly successful. The first 
dose, say twenty, thirty, or even sixty grains, should be followed, 
unless the patient sleeps, by a repetition of the remedy in one or 
two hours, but in smaller doses, say twenty grains. When sleep is 
induced, if prolonged, the patient may be aroused at the end of 
some hours, and made to take of some nourishment. Generally, he 
relapses into a sound slumber when thus aroused, without a renewal 
of the dose. Cases are reported where convulsions had occurred, 
and death seemed imminent, but which were speedily and perma- 
nently relieved, by this plan of treatment. Large doses of the 
tincture of digitalis, a tablespoonful at once, have succeeded most 
admirably, and no bad results followed. Perhaps this would equally 



144 Diseases of Adults. 

relieve, if employed in more reasonable doses, say one drachm, 
repeated every two or three hours. Even half a drachm has been 
found useful in severe cases. Chloroform, by itself, in drachm doses, 
has been quoted as giving good results. This remedy and red pepper, in 
thirty grain doses, would suit old drinkers, perhaps, better than those 
who had not so long been preparing their stomachs for such pun- 
gent articles. The bromides, in large doses, have also been reported 
as successful. 

Generally, the first attack can be cured, but each fresh attack is 
more dangerous, either as liable to a fatal termination, or to the 
induction of insanity or idiocy. 

How Avoided. By avoiding the cause. 



IV. Ailments attended with Wasting as the Prominent 
Symptom. 

Starvation. How Brought On. This ailment may occur as 
the result of privation, loss of appetite, or some incurable affection 
of the organs associated with the ingestion or digestion of food. 

How Distinguished. Starvation is characterized by a wasting of 
all the tissues; the eyes are sunk deep in their sockets; the cheeks 
are lantern-jawed, being hollow, sunken, and wan ; the skin becomes 
pale, flabby, and harsh; the joints are prominent; the muscles are 
thin, soft, and flabby; the pulse is easily compressible, and rather 
fast; the heat is generally below the normal temperature; the hair 
becomes thin, and straggling; the step is slow, and tottering, and 
evervthing betokens a want of vitality. 

How Treated. The cause must be removed, when this is possi- 
ble. If there is chronic incurable disease of the stomach, the 
oesophagus, etc., the only hope is to prolong life by the employment 
of small quantities, in frequent doses, of highly concentrated food 
and stimulants. If these cannot be retained by the stomach, or 
there exist an insurmountable obstacle to their entering this organ, 
they must be used in the form of enemas. The irritability of the 
stomach should be relieved by the appropriate remedies, mentioned 
under the appropriate head. 



Scrofula. 145 

But when starvation is the result of privation, as poverty, or 
enforced abstinence by shipwreck, etc., food should be given with 
great caution, in small quantities, of the lightest, most easily digestible 
form. The organs must be brought back to their normal condition 
very gradually, as the slightest excess may result in the loss of all 
the vantage ground. Starvation is extremely liable to result in 
scurvy, purpura, low forms of fever s and diseases of the bones. 

How Prevented. Starvation may be brought on unintentionally, 
by a systematic effort to live cheaply, or to spare food for others, 
under circumstances of privation. Hence, much may be done to 
prevent starvation, by enlarging the popular knowledge as to cheap, 
yet nutritious forms of food ; as to the valuation of grains, and the 
non-necessity of meats. Again, a patient may be starving wbile 
in the midst of plenty, because of a want of variety, the system 
becoming satiated, and refusing to assimilate what is offered it. 
The sanitarian and the philanthropist have much yet to do in this 
respect : the teaching of the poor how to live cheaply, and well ; the 
proper, most healthful modes of preparing the food for the stomach ; 
the alternation in foods, the due admixture of fish and flesh with 
grains and roots, etc. 

Scrofula. This is also known as king's evil, scrofulosis, struma, 
tubercle of the lymphatic glands, white swelling, etc. 

How Brought On. It is generally the result of inheritance, or 
the deprivation of pure air, the insufficiency of food, cold, in short, 
any form of privation will promote it, if not produce it. 

How Distinguished. There is a peculiar vitiated condition of 
the system, which causes the development of slow inflammations, 
tumors ending in abscesses, ulcerations, and a variety of forms of 
skin disease, and disorders of the mucous membranes, the glands, 
bones, etc. It most frequently occurs in the young, and is veiy 
chronic in its forms of attack, and obstinately persists, healing at 
one point and making its appearance at another. Enlargements of 
the glands, particularly of the neck, armpit, and groin, are constantly 
occurring. These sometimes soften and discharge, or may disap- 
pear without softening. In children of this constitutional taint 
there are observed enlargement of the head, swelling of the upper 
Up, or nose, of the abdomen, flabby muscles. They are generally 
13 



146 Diseases of Adults. 

of light complexion, with sandy or reddish hair, blood easy to 
inflame, and does not heal readily. Occasionally, the reverse obtains, 
the patient is dark-haired, sallow-skinned, but with all the other 
symptoms well marked. 

How Treated. When such a general predisposition presents, 
every effort must be directed to the improvement of the general 
health, and the avoidance of the causes which deprave the system. 
The nutrition must be full ; the hygiene must be carefully regarded ; 
cleanliness, ventilation, avoidance of damp, unhealthy localities, 
whether for work or for a residence. The blood must be improved 
by alterative tonics, as the iodide of potassium, and the iodide of 
iron, etc. Iodide is inseparable from its treatment. Hence, we 
have it offered us in the form of iodized milk, the iodide of ammo- 
nium, and continued with a great variety of remedies. The iodized 
milk is prepared by dissolving one part of iodine in ten of alcohol, 
and combining it with ninety parts of milk, just fresh from the 
cow. Locally, iodine is generally used to soften or drive away the 
swellings, or reduce enlarged joints, etc. It is thought, by many, 
that the best results are obtained by its use in the form of a very 
dilute ointment, thus causing absorption and not irritation, as would 
be the result of strong applications. As a remedy to aid in build- 
ing up, the cod-liver oil alone, or combined with the lacto-phosphates 
of lime, iron, potassium, etc., is very useful. Pure air and good 
food are indispensable, hence the sea shore is the best place for a 
residence, while under treatment. Dr. Lankester offers a dietetic 
salt, being common salt united with phosphoric acid, sulphuric acid, 
lime, iron, and potassium. Another preparation is a mixture of 
iron with chocolate, forming a caramel. Both of these are proper 
remedies, and should be employed along with the remedies indicated 
above. 

Complications, as strumous ophthalmia, etc., must be met as they 
arise. 

How Prevented. The means of prevention are indicated in the 
above. 

Poverty of the Blood. This is known as anaemia, bloodless- 
ness, watery blood, etc. 

How Brought On. Poverty of the blood may be the result 



Poverty of the Blood. 147 

of a loss of blood from a hemorrhage, as caused by injury or disease ; 
over lactation, or suckling too long continued; any exhausting dis- 
charge, as diarrhoea; want of nourishing food; or privation and 
misery of any kind ; or it may be due to the influence of poisonous 
air, like that of a malarious neighborhood. 

How Distinguished. The patient suffering from this state of 
the blood is extremely pale, thin, weak, easily fatigued, every exer- 
tion causing palpitation of the heart, every little excitement causing 
great nervousness. Blood drawn, or the result of an injury, is thin, 
pale, and watery, showing a want of the red coloring matter. In 
young, growing persons, especially girls, these symptoms are very 
apt to be present, showing a growth of too rapid a nature, without 
the proper amount of fresh air, exercise, and nourishing food. 
There is generally a depressed state of the mind ; the sleep is either 
too profound and not refreshing, or disturbed; in some, there is 
ringing in the ears ; swelling of the feet and hands often are pres- 
ent, and almost invariably there is more or less swelling beneath the 
eyes, which are surrounded with a dark ring ; as a general rule, the 
appetite is much impaired ; it may be wanting, or appear insatiable 
and capricious, with a desire for strange food. Very many cases 
of long standing have vague pains, and suffer greatly from neu- 
ralgia, generally in the head and face. 

How Treated. The indications for treatment are plain. Every 
effort must be made to build up the blood. The patient should be 
required to have plenty of fresh, pure air, light exercise, as it can 
be taken, and highly nourishing diet. The medical treatment will 
consist in tonics, particularly those containing iron. Among the 
numerous iron preparations, it may be necessary to ring the changes, 
as the patient soon appears to tire of one long continued. Again, 
certain forms appear to agree better with some persons than with 
others. Perhaps the muriated tincture of iron, combined with qui- 
nine, or some preparation of cinchona, will be found most useful. 
To this may be added, dilute phosphoric acid, or these may be com- 
bined, in pill form, as quinine and the phosphate of iron. In 
extreme nervousness, the valerianate of iron is useful. Strychnia, 
or nux vomica, often greatly aids in relieving the muscular debility. 
Where there is a scrofulous tendency, the iodids of iron, preferably 



148 Diseases of Adults. 

the syrup of the iodide of iron, with or without some cinchona pre- 
paration, is very beneficial. In young girls, particularly, there is apt 
to be a want of tbe menstrual flow, while in all women suffering 
with poverty of the blood there is more or less disturbance or 
irregularity in tbis function. Here, the muriated tincture of iron, 
or syrup of the iodide, with quinia, proves extremely valuable. 

Of course, hemorrhage, from any source, must be stopped, and 
the solution of the sulphate of iron, combined with some form of 
ergot, rarely fails to meet this indication. 

How Prevented. The causes, as above detailed, indicate the pre- 
vention. Remove any drain upon the system, as suckling, 
hemorrhage, overwork; enforce ventilation, exercise. 

Night-Sweats. This is called colliquative perspiration. 

How Brought On. Night^sweats are always tbe result of great 
debility, and are usually associated with consumption of the lungs, 
hence the dread with which this symptom is regarded. 

How Distinguished. Strictly speaking, profuse perspirations, 
though often occurring at night, may occur at any time. When 
the result of phthisis, they are preceded by the hectic fever, 
a flushed face, etc., which commences in the evening, reaches its 
height at midnight, and terminates in a drenching sweat. When 
the result only of debility, they follow a serious and debilitating 
illness, or a general languor, and are induced by the most trifling 
exertion. Sometimes, in consumption, the sweating disappears, and 
is replaced by an exhausting diarrhoea. 

How Treated. Night sweats, or profuse perspiration, at any 
time, when not the result of a consumptive tendency, can readily 
be checked by the free use of the astringent tonics. In all cases, 
every effort should be made to build up the strength, by good, 
easily digested diet, proper ventilation and regulation of the tem- 
perature. Occasionally, the heat of the room in which the patient 
lives is such as greatly to contribute to the keeping up of this symp- 
tom. The mineral astringents in full doses, given freely diluted, 
have a marked effect in checking sweats. In some instances, the 
position, as sleeping in a chair, in place of lying in a bed, will pre- 
vent, at least for a time, this profuse flow. When the bowels are 
not prone to diarrhoea, we dilute sulphuric acid, in doses of fifteen 



Dropsy. 149 

to thirty drops, in sweetened water, with generally a good result. 
The body should be sponged at the hour of retiring, with vinegar 
and water, alum dissolved in whisky, or some similar astringent 
wash. Internally, the vegetable astringents are useful, particularly 
when there is a tendency to looseness of the bowels. Of these, the 
tinctures of kino, krameria, or catechu, are most valuable. The 
muriated tincture of iron, the subsulphate of iron, the syrup of the 
iodide of iron, the ammonio-citrate of iron, all act well in relieving 
the sweating. 

How Prevented. In consumptive cases, the only hope is the 
careful regulation of the temperature, and the husbanding of the 
patient's strength. As these sweats are not only very exhausting, 
but are liable to cause additional trouble by the "taking cold," after 
a severe illness, every effort should be made to ward them off, by an 
early resort to tonics, full diet, etc. 

Dropsy. This is known by a variety of names, according to its 
location, as anasarca, or general dropsy ; ovarian dropsy ; hydrocele, 
or dropsy of the testicles; hydrocephalus, or dropsy of the head; 
oedema, or dropsy of a part where the water is located just beneath 
the skin ; etc. 

How Brought On. As by the general term, dropsy, is meant 
that form witnessed in the abdomen or feet, this form alone will be 
discussed. It is generally due to a sudden stoppage of sweating, as 
by cold; thinness of the blood, as in ansemia; or some mechanical 
obstruction of the circulation of blood in the veins. It may result 
from heart disease, kidney disease, liver disease, or may follow any 
exhausting sickness. 

How Distinguished. The first symptom showing the presence 
of dropsy is a gradual, painless swelling of the part. In the abdo- 
men it is shown by great enlargement, want of tenderness, a dull 
sound on percussion, or gently striking the part. Striking with one 
hand, at one side, will cause a wave of the fluid to pass to the other, 
and strike against the hand placed on that side. Along with this, 
there is emaciation of the whole system, the appetite is poor, the 
patient is easily fatigued, and when the swelling is great, there is 
more or less difficulty of breathing. The swelling is regular and 
even, and not in lumps or irregularities, as in the case of a tumor. 
13* 



1 5 o Diseases of A dults. 

If an abscess caused the swelling, there would be more or less pain 
at the seat of inflammation, and the other characteristic symptoms 
of that affection. As the dropsy increases, there is correspond- 
ingly increasing inability to lie down, for the water interferes with 
the lungs and heart more when the patient is in a recumbent 
position. 

How Treated. When it is rather sudden in its appearance, it is 
called acute dropsy, in contradistinction to the slower or chronic 
form. This being the result, generally, of suppression of perspira- 
tion, or of the action of the kidneys, what are known as diuretics 
should be used, with free purgation. Jalap and cream of tartar in 
large doses, with plenty of water, rarely fail to act well and bring on 
copious watery discharges from the bowels and bladder. These may 
be given in infusion of juniper berries, or broom; and along with 
them, at proper intervals, the acetate of potassa, sweet spirits of 
nitre, etc., are valuable. Free purging may generally be obtained 
by the elaterium, say, in doses of a fourth, or a third of a grain, 
every three or four hours, till it acts freely. Digitalis formerly was 
thought to act favorably, but it is now falling into disfavor. When 
it is due to debility, along with these remedies, should be given the 
proper tonics, to bring up the blood to its proper standard. Care 
should be had. not to further exhaust the strength by these purga- 
tives, etc. When the parts are so swollen as to become painful, or 
to interfere with the breathing, etc.. as in the abdominal form, tap- 
ping becomes necessary; or when it is in the lower extremities, 
great relief may be obtained by a number of minute punctures 
through the skin, so as to let the fluid escape. 



V. Ailments attended with Insensibility as the Promi- 
nent Symptom. 

Fainting. Known, also, as syncope, a swoon, or swooning, 
feinting fit, etc. 

How Brought On. This may be the result of any sudden emo- 
tion, debility, heart disease, an injury, etc. 

How Distinguished. The patient suddenly loses consciousness, 



Apoplexy. 1 5 1 

and falls or sinks to the ground. There is general pallor, apparent 
or total suspension of respiration, the heart's action is so feeble that 
it can scarcely be felt, or heard when the ear is placed over the side, 
the limbs are relaxed and motionless. It is distinguished from 
epilepsy by the absence of the frothing, the previous history, etc. 
Generally, the attack soon passes off, and the patient " comes to," as 
it is called, and gradually the functions are resumed. 

How Treated. As fainting, if prolonged, may cause death, or 
serious injury to the system, by the formation of dots in the 
heart, it is very important that the fit should be shortened, and the 
consciousness restored. Perhaps the most valuable means to this 
end will be, to place the patient prone on the ground, so that the 
head shall be on a level with or below the body, the clothes loos- 
ened, so that no impediment may exist to the free circulation of the 
blood. This will insure the brain being kept full of blood, which 
serves to restore the nerve power necessary to reanimate the heart. 
In persons liable to faint, by reason of debility, hemorrhage, etc., 
it should be remembered that fainting cannot occur so long as the 
brain is kept full of blood. For this purpose, the head should be 
kept low, the pillows, etc., removed, and the feet and body elevated. 
To aid in restoring animation, cold water may be dashed suddenly 
in the face, stimulants may be placed in the mouth, and caused to 
rundown the throat; hartshorne or smelling salts maybe applied to 
the nose. In cases of fainting from emotion, where there is plenty of 
blood, bleeding from the arm may be resorted to. In addition, the 
limbs may be vigorously rubbed. 

How Prevented. This is sufficiently indicated in the foregoing. 

Apopiexy. How Brought On. This is generally the result 
of age, though it is occasionally seen in the young or middle-aged. 
As age advances, the blood vessels of the brain become less able to 
retain their contents, and some sudden emotion, a full meal, over- 
stimulation, a strain, as at stool, or in lifting, causes a rupture 
at some point, the blood is poured out, and either causes instant 
death, or forms a clot, by whose pressure life is hastened to a close. 
Those predisposed to apoplexy are short, thick-necked people, of 
indolent habits, and high-livers. Excessive mental effort also 
superinduces such an attack. Again, the wearing of a tight cravat, 



152 Diseases of Adults. 

which, by its pressure, hinders the return of the blood from the 
brain. 

How Distinguished. When it is the result of the rupture of a 
blood vessel in the brain, there are rarely any premonitory symptoms. 
Generally, it is sudden; a stroke, as it is often called; the patient at 
once falls, unconscious ; breathing more or less like snoring, called 
stertorous ; the cheeks puffing out and in, the pulse slow, generally 
full ; the face is dark, livid. This may continue from a few min- 
utes to several hours, and is followed by more or less paralysis, with 
affection of the mental powers. When it is caused by congestion 
or fullness of the brain, the face, for some time previously, is flushed ; 
the eyes are red and bulging ; there are heat, throbbing of the ves- 
sels of the head, headache or vertigo, or both ; the sight is more or 
less impaired. The patient has also been costive, dull, drowsy, and 
complaining of a fullness of the head; these symptoms are followed 
by sudden stupor, with stertorous breathing, pulse labored aud slow, 
and the face flushed and livid. Generally, the total unconscious- 
ness is brief. There might be slight convulsive movements. After 
recovery, the paralysis is generally but of temporary duration. 

The history aids much in distinguishing this effect. Thus, tht 
absence of the fumes of liquor, etc., show that it is not drunken- 
ness, or poisoning by opium, or some similar drug. If it were the 
result of concussion or compression, there would be the evidences 
of injury. Fainting would be known by the presence of paleness, 
coldness, and the loss of pulsation. 

How Treated. Of course, the age of the patient will have much 
to do with the decision as to the probabilities of entire recovery ; 
the younger the patient, the better prospect exists. When there 
are evidences of plethora, or an abundance of blood, bleeding .may 
be employed to relieve the tension on the vessels of the brain. 
This operation should be performed with care, watching the effect. 
When solely due to congestion, a free bleeding will often give com- 
plete relief, but should be followed by rest, care in diet, free purga- 
tion. When it is doubtful as to the use of bleeding, cups, cut or 
dry, may be applied to the nape of the neck, and mustard plasters 
along the spine, on the legs, and stomach. Injections into the 
lower bowel will aid during the first of the attack, and these should 



Falling Sickness. 153 

be followed by free purgatives, particularly tbose of a saline char- 
acter. The head should be elevated, and kept cool by the use of 
wet cloths, or a bladder filled with ice. In cases occurring in broken 
down or aged persons still more care is required, lest the trouble be 
rendered permanent by still further hemorrhage, or other injury to 
the delicate organism of the brain. 

How Prevented. This will be met by the avoidance of excessive 
brain work, care as to diet and drink, in all cases where, from age 
or other reasons, an attack is likely to occur. 

VI. Ailments attended with Fits as the Prominent 

Symptom. 

Falling Sickness. This is known as epilepsy. It is an attack 
of convulsions, with unconsciousness, and which recurs from time 
to time, without any regularity. 

How Brought On. This may, and often does, result from 
parentage, intemperance, or excesses of any kind ; injuries to the 
head, or fright. 

How Distinguished. In many instances an attack is ushered in 
by a headache, vertigo, a sudden feeling of terror, or what is called 
the aura ; a feeling as though something were creeping up a limb, or 
a wind were blowing on it. This extends slowly upward, and then 
the patient screams, starts, and falls suddenly, convulsed, foaming, 
grinding the teeth ; the face is flushed, the eyes roll wildly, respira- 
tion is performed with difficulty, and there may be vomiting and 
involuntary passages. This lasts usually five or ten minutes, the fit 
passes off, the patient goes into a sleep, or a drowsy state, or may 
arise bewildered, and stagger on his way, with more or less head- 
ache, weakness, or even delirium and frenzy, which impels to attack 
those around. A fresh attack may occur in a few minutes, or 
hours ; or even months may elapse before a renewal. 

How Treated. During the fit but little can be usefully attempted. 
The patient should be cared for, and placed so that no injury may 
result from striking his limbs or head as he tosses about. The 
clothing should be loosened, and he should be allowed plenty of 
fresh air. If prolonged, ether, chloroform, or nitrite of amyl may 



154 Diseases of Adults. 

be given, by inhalation, to arrest its continuance. Tbe special effort 
will be to prevent a recurrence, and for this purpose, many and 
diverse remedies have been proposed. Perhaps the best results have 
been obtained from the valerianate of zinc, one grain, two or three 
times a day; the bromide of potassium, in full doses, and continued 
for a long time, say 15 to 30 grains, three times a day, for months; 
digitalis, bromide of ammonium, conium, tincture of assafoetida, 
and chloral. The latter was given just prior to the expected par- 
oxysm. The nitrite of amyl, also given at this time, say as the 
aura was commencing, has been found eminently valuable. 

How Prevented. This indication will be met by the careful 
avoidance of the causes; by living temperately, yet using nutritious 
diet, keeping away from all excesses, avoiding all bad habits, and 
taking regular exercise in the open air. Tobacco, especially, should 
be avoided, as highly detrimental. The bowels should be kept as 
regular as possible. 

Hysterics— hysteria, a "fit of hysterics." This was supposed 
to be caused by the womb, and hence its name, but it is seen also 
in the male, occasionally, and while womb affections predispose to it, 
it may be caused by general weakness, or excitability of the nerves. 

How Brought On. Any mental emotions, fatigue, or unusual 
effort, may cause it in those wbo are depressed. 

How Distinguished. It is characterized by a fit or attack of 
uncontrollable laughing, crying, or even convulsive movements, like 
epilepsy, though without loss of consciousness. It is preceded and 
accompanied by a choking sensation, as though something were in 
the throat, which the patient in vain tries to swallow. Some per- 
sons who are subject to this disease will have a variety of other 
troubles, such as a short, hacking cough, loss of voice — yet which, 
on occasion, is found to be only simulated — retention of urine, loss 
of power in one or more limbs, etc. 

How Treated. The paroxysm may generally be relieved by 
soothing attentions, valerian, assafoetida, etc. In the intervals, the 
system must be built up with a good diet, iron, quinine, strychnia, 
etc., with bromide of potassium, valerianate of ammonia, camphor, 
and similar remedies, and chloral, as may be found requisite to 
relieve excitement and produce sleep. The prevention of a return 



St. Vitus' Dance. 155 

may be guarded against by regulated exercise in the open air, the 
avoidance of all excitement, sea bathing, traveling, and a proper 
occupation, to prevent the mind dwelling upon any sources of 
trouble. 

St. Vitus' Dance. This is also known as chorea. 

How Brought On. Chorea generally occurs in debilitated child- 
ren, especially girls from the age of eight to fifteen, or when puberty 
commences, the occurrence of which often appears to act as a cure 
of the trouble. It results frequently from rheumatism in the acute 
form, from general debility, fright, excitement, fatigue, great men- 
tal effort. 

How Distinguished. It is characterized by incessant movements 
of the hands, the feet, the face, the tongue, in fact, of the wbole 
body. These are irregular, and appear beyond the control of the 
patient. They interfere with walking, working, and speech, but 
cease entirely during sleep. 

How Treated. The disease may last for many months, but gen- 
erally improves in a month or less. It may produce mental derange- 
ment. When it follows a rheumatic attack, it is more apt to be 
obstinate, and the appropriate treatment, iodide of iron, is best, 
combined with nutritious diet, sea bathing, and regulated exercise 
in the open air. In protracted cases, cimicifuga has proved very 
useful, as well as arsenic, sulphate of zinc, and bromide of potas- 
sium. When the attack is very distressing, chloral will be found 
of great service. In every instance, the patient should be guarded 
against annoyance from the thoughtlessness of those around him ; 
and separation will be best, both for this purpose, and lest sympa- 
thetic imitation, or intentional mimicry, induce it in others. 




CHAPTER V. 

AILMENTS OF PARTS OF THE BODY. 

Section I.— Ailments Seated in the Air Passages.— Cold in the 
Head— Cold in the Chest— Sore Throat— Asthma— Pleurisy— Pneumonia 
— Consumption. 

Section II.— Ailments Seated in the Food Passages.— Dyspepsia- 
Colic— Constipation— Diarrhcea— Dysentery— Cholera— Jaundice. 

Section III.— Ailments Affecting the Blood Passages.— Heart 
Disease— Swelling of Arteries. 

Section IV.— Ailments Affecting the Waste Passages.— Kidney 
Diseases— Diseases of the Bladder— Diabetes. 

Section V.— Ailments Seated in the External Covering of 
the Body.— Diseases of the Skin— Of the Hair and Nails. 

I. Ailments Seated in the Air Passages. 

Cold in the Head. Under this term will come coryza, catarrh 
of the nose, snuffles, sneezing, rose cold, hay asthma, hay fever, 
summer catarrh, influenza, and with symptoms extremely similar, 
we may consider ozoena, and polyps in the nose. 

How Brought On. An attack of coryza, catarrh of the nose, 
snuffles, or cold in the head, is the result of an exposure to a draught, 
bareheaded, or when heated, and perspiring freely. 

How Distinguished. The patient's eyes and nose run freely; at 
first, however, the eyes are suffused and watery, but the nose dry, 
swollen, and irritable ; the air will not readily pass through it, the 
smell is lost, and constant efforts are involuntarily made to clear the 
passage. Sneezing occurs on every access of cold air. The distress 
extends up to the forehead, there are pain, headache, chilliness, and 
slight fever. As the cold seems to break, a free, watery discharge 
commences to flow from the nose, which may be enormous in quan- 
tity. 

156 



Ozcena. 157 

How Treated. The attack is generally readily broken up by a 
mustard foot bath, warm drinks, and twelve grains of Dover's 
powder at bed-time. When the fever is high, the solution of the 
acetate of ammonia, two tablespoonfuls in a tumbler of water at 
bed-time, will usually relieve this symptom. Many persons abort 
such an attack by one large dose of quinine, or by a hot lemonade 
at bed-time, and sweating it off. 

Rose Cold, or June cold, hay fever, summer catarrh, autumnal 
catarrh, hay asthma, as it is variously called, is the result, not of 
cold, but of a peculiar source of irritation, as the odor of new-mown 
hay, of roses, ipecacuanaha, etc. 

How Brought On. It occurs only in the spring, latter part of 
the summer, and fall, and only in those predisposed to it. Some 
have a similar attack from sleeping upon pillows or beds of duck 
feathers, and from a singular variety of causes. 

How Distinguished. The symptoms are the same as those of a 
cold in the head, but can generally be traced to an exciting cause, 
as the proximity of hay, etc. 

How Treated. This is still a matter of earnest consideration to 
many. In a number of cases, the only relief that can be hoped 
for, is to fly from the cause. Many have found the greatest benefit 
from the application of a saturated solution of quinine to the nos- 
trils. The tincture of lobelia is a favorite remedy ; the sulphates 
of iron and quinine, combined, have proved very useful ; some are 
relieved by filling the air with the vapor of chloride of lime, or 
soda, and lately, arsenic. Three to five drops of the solution, given 
immediately after meals, has acted in a highly favorable manner in 
a number of cases. 

Influenza having been treated of in a previous chapter, it will 
be unnecessary to again consider it. 

Ozcena is an ulceration of the nose, originating in a scrofulous 
system, or one tainted with syphilis. 

How Distinguished. This affection is characterized by a dis- 
charge from one or both nostrils, of a fluid of a very offensive odor, 
thin, irritating to the surface over which it flows, and aggravated 
by cold. In syphilitic cases, it almost invariably occurs from both 
nostrils ; while in scrofulous cases, but one is apt to be affected. 
14 



j r s Diseases of Adults. 

This sometimes runs down the back passage, and getting into the 
throat or stomach, causes nausea, vomiting, loss of appetite. Occa- 
sionally, in severe cases, thickened masses, like scabs, drop, or are 
blown from the nose, and finally, decay of the bones takes place, 
and causes great deformity. 

How Treated. This disease, which is also often known as 
catarrh of the nose, requires care in its treatment. When of syphi- 
litic origin, iodide of potassium, and mercury, in full doses, are 
requisite. In the other form, syrup of the iodide of iron, cod-liver 
oil, good, nourishing diet, cleanliness, and fresh air, are the neces- 
saries. Locally, to relieve the odor, etc., lotions may be used, of 
chlorinated soda, chloride of zinc, sulphate of copper, carbolic acid, 
permanganate of potassa, etc., by means of the nasal douche, at 
least twice each day. 

It should be remembered that similar symptoms may occur from 
the presence of a foreign body in the passage, or even general ill 
health. Here, iron tonics, good diet, and lotions of disinfectants to 
the nose, are all that will be required. 

Polyps in the Nose will often give rise to the belief of the 
presence of a cold in the head. The nostril is choked, and 
after much effort, portions of hard, bloody mucus are forcibly 
expelled. There is generally a feeling of weight and fullness about 
the nose; a thin, bloody, odorous discharge often occurs. 

How Treated. When small, the insufflation of an astringent, 
the best is tincture of chloride of iron, or solution of subsulphate 
of iron, twice or thrice a day, will relieve the symptoms, and cause 
the polyp to shrink and fall off. When large, and in some instances 
they become enormous, an operation is necessary. A polyp forceps 
must be passed up, with great care, and the polyp may then be 
seized and twisted off. 

Cold in the Chest. This will include bronchitis, catarrh of 
the chest, catarrhal fever, coughs and colds. Bronchitis or inflam- 
mation of the bronchial tubes, or tubes which run to the lung, is 
an affection of the lining membrane or mucous membrane of these 
tubes. 

How Brought On. This is generally the result of exposure to 
cold, but may also occur from certain occupations, as knife or tool 



Cold in the Chest. 159 

grinding, stone-cutting, in short, anything by which particles of irri- 
tating matter may enter the tubes and set up inflammation. 

How Distinguished. There are fever, tightness with soreness of 
the chest, at first a tight, dry cough, which becomes loose, with ex- 
pectoration of a white frothy matter ; or, in bad cases, filled with pus 
or shreds of membrane. 

How Treated. A cold in the chest, in its early stages, may 
often be cut short by the same treatment indicated for a cold in the 
head. A full dose of quinine; a hot lemonade, or ginger tea 
at bed-time ; a hot mustard foot-bath, and a full dose, say ten grains, 
of compound powder of ipecacuanha at bed-time. Profuse per- 
spiration results, and the cold is broken, leaving a little debility, 
which must be treated with generous diet and tonics. When pro- 
longed, a free purgation with a saline is best, followed by tartar 
emetic, grain one-eighth, every two or three hours, with liberal 
draughts of some mild fluid, as flaxseed tea. A mustard plaster 
over the chest, or frictions with turpentine, will aid in relieving the 
difficulty. If there is nausea, or a tendency thereto, syrup of ipe- 
cacuanha, one-half teaspoonful every three or four hours, will relieve 
the cough and respiration. If very troublesome, squills and pare- 
goric may be given, particularly to enable the patient to sleep at 
night. Care should be observed in using opium and its prepara- 
tions, lest the cough be made tight, and dangerous results be brought 
on. Stimulating expectorants are often necessary when the phlegm 
is tenacious, as the decoction or syrup of senega, chloride or car- 
bonate of ammonia, etc. To keep up the strength, quinine, beef- 
tea, wine-whey and spirits may be necessary. Inhalations, as of 
steam, the infusion of hops, etc., often greatly relieve the air pas- 
sages. Poultices of hops, Indian meal, and mustard, are useful, 
particularly in children. 

Should the disease become chronic, croton oil, tincture of iodine, 
and plasters of hemlock or pitch may be applied to the chest, while 
tonics, stimulating expectorants and alteratives are used. In these 
cases, pure fresh air is valuable, and can do no harm, though this 
is generally prohibited, lest they should take fresh cold. 

How Prevented. Cold in the chest may be prevented by keep- 
ing the chest and arms well protected in cold weather, and the feet 



160 Diseases of Adults. 

from dampness. Cod-liver oil and syrup of the iodide of iron con. 
tinued for a long time will strengthen the system of one predis- 
posed to this affection, and secure immunity from repeated attacks. 

Sore Throat will include laryngitis, tonsillitis, quinsy, hoarse- 
ness, loss of voice, clergyman's sore throat, putrid sore throat, diph- 
theria, and diphtheritic sore throat, throat ulcers and relaxed uvula. 

Laryngitis, or inflammation of the larynx, is the most common 
form of sore throat. Tonsillitis, or inflammation of the tonsils, 
when very severe, is known as quinsy. Aphonia, or loss of voice, 
is apt to be only partial. Clergyman's or orator's sore throat is 
generally the result of straining the voice, and does not occur so 
frequently as formerly, now that public speakers are learning to 
use their voices. Hoarseness may result from straining the voice, 
slight cold, debility, etc. 

How Distinguished. Laryngitis is accompanied with sore throat, 
hoarseness, short dry cough, and more or less pain in breathing. 

Tonsillitis shows, in addition to these symptoms, great swelling 
and redness of the tonsils, producing loud, hoarse breathing, inter- 
fering, to a degree, also, with the hearing. As it progresses, the pain 
becomes constant and throbbing, there is great difficulty in swallow- 
ing, and finally the abscess breaks or is opened artificially. 

How Treated. In all cases of sore throat, free purgation is best 
at the outset, and especially by the use of cooling aperients, as the 
citrate of magnesia, etc. If the inflammation is great, leeches may 
be applied to the throat. The inhalation of steam, by placing the 
head over a vessel of boiling water, gives great relief. When there 
is ulceration of the throat, the atomizer may be used, with lauda- 
num, hops, hyoscyamus, etc., in the vapor. When the swelling, 
etc., are great, after leeching, poultices of hops, flaxseed, etc., may 
be applied, and the throat bathed from time to time with a stimu- 
lating liniment, as hartshorne liniment, or painted with tincture of 
iodine. In ordinary sore throats, gargles are useful, as alum water, 
sage tea, honey, borax and water, and demulcent drinks, as flaxseed 
tea, gum arabic, or slippery elm water. In children that cannot be 
made to gargle, a good plan is to blow finely pulverized alum or 
borax into the throat, through a quill, or a folded paper, or tube of 
any kind. When the tonsils remain enlarged, they should be re- 



Diphtheria. 161 

t*,oved by the knife or scissors. Great care is necessary lest a large 
vessel be opened, and severe hemorrhage result. Ulceration and re- 
laxation of the uvula may be treated with a gargle of alum, 
or rubbed with some astringent, as sulphate of zinc or copper, to 
the ulcers. For the preparation of steaming, inhalations, and 
gargles, see pages 346, 347, and 350. 

Loss of voice may require the application of electricity, or blis- 
tering of the back of the neck. Singers and others find great re- 
lief by allowing a piece of borax to dissolve slowly in the mouth, 
swallowing the solution as it forms. In all these affections, fresh 
air and tonics are indispensable (see p. 360). 

Diphtheria, diphtheritic sore throat, putrid sore throat, may vary 
from a simple sore tbroat, with the formation of false membrane, to 
the malignant form. 

How Brought On. It is the result of an epidemic influence, 
which acts with greater intensity in proportion to its being confined, 
as in a poorly ventilated, crowded locality. It may be carried from 
person to person, but only under the favoring influences. 

How Distinguished. Prior to the appearance of the peculiar 
symptoms of the disease, there are languor, uneasiness, sore throat, 
and swelling of the glands of the throat. Fever sets in, headache, 
etc., and difficulty of swallowing. Examining the throat shows the 
parts swollen, red, and purple, followed, in a day or two, by a coat- 
ing of a dirty, or yellow white, like wet buckskin. At the end of 
eight or nine days, this begins to loosen, cleans off, and recovery 
commences. In the severe cases, all these symptoms are aggra- 
vated; in children, the membrane causes a croupy cough, and the 
most energetic efforts to obtain breath, the patient becoming livid, 
and evidently strangling. In what is known as the malignant form, 
the first onset is with intense pain in the head, high fever, 
nausea and vomiting, and even bleeding from the mucous surfaces. 
The coating is very dark, ash-colored, leathery, and exhales an offen- 
sive odor. Prostration rapidly ensues, followed by stupor and 
death. 

How Treated. There is a great variety of treatment proposed, 
but none seems to be fully satisfactory. If obstinate constipation 
be present, moderate purgation may be employed. Perhaps the 
14* 



1 62 Diseases of Adults. 

treatment most lauded, and which seems to have given most success, 
is the chlorate of potassa, with the tincture of the chloride of iron, 
say fifteen to thirty drops of the latter, in a wineglass of water, 
with twenty to thirty grains of the former, every three or four hours. 
Quinine may be used, and good diet, in a liquid form, eggs, milk, 
beef-tea, punch, etc. Gargles may be used, of solution of chlorine, 
permanganate of potassa, sulphite of soda, and carbolic acid. Or, 
these, in more concentrated form, may be applied, mixed with honey, 
to the parts, by means of a swab or brush ; ice is very soothing and 
agreeable, when allowed to dissolve in the mouth, in small quanti- 
ties. Among the internal remedies, all the above gargles may be 
placed ; and we may also employ, with advantage, the gargle of 
lime-water, on page 347. 

Asthma. The form of this disease known as hay asthma has 
already been considered. 

How Brought On. Asthma is most frequently inherited. It is 
brought on by exposure to irritating fumes, by indigestion, by lung 
disease. It is really a spasm of the very small tubes of the lungs, 
and the attacks are generally preceded by mure or less irritability, 
drowsiness, headach 

II< no Distinguished. The attacks almost invariably occur in the 
night, and the patient is roused by a sense of suffocation, he rushes 
to the window and leans out, regardless of the weather, in the effort 
to get breath. Every symptom marks the difficulty of breathing 
and the dread of suffocation. The breathing is wheezing, the face 
is pule, anxious, cold, or even livid; perspiration is profuse, llelief 
comes with a discharge of mucus in thick lumps. The attack may 
last from a few minutes to hours. The intervals are very irregular — 
every night, once a month, or the attack not appearing for many 
months. 

How Treated. During the spasm, relief may be obtained by 
smoking stramonium leaves ; breathing air filled with the fumes of 
burning paper, soaked in a solution of saltpetre; inhaling ether, 
nitrous oxide or nitrite of amyl; hypodermic injections of mor- 
phia; by wine of ipecac, tincture of lobelia, both till nausea is 
produced ; chloral, mustard to the feet and shoulders, inhalations, 
as Nos. 158, 159, page 351. 



Pneumonia. 163 

In the intervals, keep the system in good order, build up, if 
necessary ; give bromide of potassium, in quite full doses, say fifteen 
to thirty grains, three times a day, for many weeks. Where prac- 
ticable, change of climate is, perhaps, the surest remedy, and often 
relieves permanently. 

Pleurisy, or inflammation of the pleura, is often known as a stitch 
in the side. It may be single or double, that is, on one or both sides. 
It consists of an effusion of water between the lungs and the walls 
of the chest. 

How Brought On. It is the result of exposure to cold, a broken 
rib, a wound, cancer, or consumption. 

How Distinguished. It is almost always preceded by a chill or 
chilliness, then a sharp, cutting pain in the side follows, which 
prevents full respiration, with fever, and a short cough. The pain 
can be located, and is increased by motion, breathing, coughing and 
pressure. As effusion occurs, the pain, etc., are diminished, though 
the difficulty of breathing becomes more intense. When the effu- 
sion is great, life is placed in great jeopardy. 

How Treated. The effort must be to cut short the attack, and 
thus lessen the liability of dangerous effusion, or adhesions, which 
limit the breathing capacity. In high fever, at the outset, a full 
bleeding is useful, especially in young and plethoric persons. Then 
leeches or cups to the parts. Free purgation is always necessary, 
and, generally, great good follows the use of tartar emetic, calomel, 
and opium, say one-eighth grain of the first, , one-half grain of calo- 
mel, and one grain of opium, repeated every three or four hours. 
Hot fomentations (p. 346) may be applied for the pain, and hot 
poultices to the affected side. Others suggest rest, by broad strips of 
adhesive plaster to the side, thus preventing its motion in breathing. 
If effusion of water occurs, blisters, and uva ursi tea (p. 348), or 
juniper tea (p. 349), will be useful, or, in some cases, tapping, to 
draw off the matter that may have formed, and prevent the action of 
the lung by its presence. 

Pneumonia, or inflammation of the lung, is known, also, as lung 
fever, and as bilious or typhoid pneumonia. 

How Brought On. It is caused by exposure to cold or damp ; 
by injury, as a fractured rib; by position, as in fevers, etc., where 



164 Diseases of Adults. 

the position favors the flow of blood to the part, and obstructs its 
return, producing congestion, which may result in pneumonia. 

How Distinguished. A chill and fever, accompanied with op- 
pressed respiration, a dull pain in the lung, a short cougb, followed 
soon by rusty expectoration. This is the peculiar sign, the spittle 
tinged with blood. The disease gets to its height about from the 
seventh to the ninth day, when, in mild cases, the symptoms im- 
prove and recovery goes on. In fatal cases, the debility increases, 
the breathing is more oppressed, the cough is more troublesome, 
and the expectoration is filled with pus. Death follows as early as 
the seventh day, but may be postponed until the end of the third 
week. Or, it may become chronic pneumonia, where, from the in- 
flammation, the lung hardens, and becomes solid, resembling the 
liver in its appearance. It may be complicated with pleurisy, pleuro- 
pneumonia; with inflammation of the liver, bilious pleurisy; con- 
sumption; or the prostration, etc., may be so great, from the 
beginning, that it may be typhoid-pneumonia, called, also, "winter 
fever." 

How Treated, In mild cases, by care, proper food and rest, the 
majority will recover without any medical treatment. In those more 
severe, except where the debility is very great, bleeding moderately, 
at the outset, may cut short its duration, and lessen its dangers. 
Cupping directly over the seat of disease is preferable, and always 
useful. The bowels should be unloaded, the fever, etc., reduced 
by syrup of ipecac, in teaspoonful doses, but this remedy should 
be watched, lest it add to the prostration. Others prefer the solu- 
tion of acetate of ammonia, a tablespoonful of which, in half a 
tumbler of water, may be taken every two hours. After this, beef 
tea, and other good food, with small doses of ipecacuanha, carry the 
case on safely. Rest is so important, that some strap the side, as 
for a fractured rib. Support is absolutely necessary, by the use of 
concentrated liquid food, and stimulants must be given the moment 
debility is present. Blisters to the part are always valuable, and 
aid greatly in relieving the affected lung. These may be repeated, 
or followed by dry cups, hot poultices, etc., and when solidification 
occurs, tincture of iodine, croton oil, or other irritants (see p. 343), 
may be applied, to induce absorption. 



Consumption. 165 

How Prevented. By avoiding exposure, wearing flannel under- 
garments, high in the neck, and with long sleeves, and thus protect- 
ing the chest. 

Consumption, tuberculosis, or phthisis, will include bleeding 
from the lungs, or spitting blood, and night sweats. 

How Brought On. This is almost invariably hereditary, but 
may occur by change of climate, and at the same time, change from 
an out-door country life to one in a large city, where the home is 
situated in a small, ill ventilated, never too cleanly street, and where 
the occupation almost constantly necessitates in-door life. This 
accounts for the mortality by this disease, among the immigrants 
from Ireland to America. 

How Distinguished. The approach is rapid, or slow. It may 
commence as a sequel to pneumonia, bronchitis, etc. A slight 
cough, a hemorrhage, debility, a fit of indigestion, a hoarseness, 
mark its onset. These slowly, sometimes suddenly, increase, with 
paleness, pains in the chest, quick pulse, then hectic fever, night 
sweats, diarrhoea, exhaustion, and death. 

These symptoms are variable. Occasionally, improvement occurs, 
or there is an arrest of the progress, and hope of recovery is cre- 
ated, often to be lost by a renewal of the symptoms and a more 
rapid decline. Indigestion almost invariably accompanies the whole 
progress of the attack. Loss of menstruation often is the first 
symptom, with the female, to excite fear. In long cases, the 
emaciation, and all the symptoms, become painful to witness. The 
expectoration is mucous, mixed by degrees with pus, or blood, and 
in very many cases becomes coin-shaped, and partially floats when 
ejected into a basin of water. 

Percussion and auscultation of the lungs show the progress of 
the disease in the lungs. Dullness, and want of proper respiration 
commence at the apex, or top, and make their way downward. As 
the diseased spot softens, gurgling, or crackling, as of the separation 
of wet surfaces, is heard. When there is a cavity, known as a 
vomica, the voice of the patient sounds just beneath the ear of the 
listener, when applied to the spot, and there is deep breathing, or 
cavernous respiration. 

How Treated. While instances have occurred, of the arrest of 



1 66 Diseases of Adults. 

this disease, and an apparent approach to health, these are so rare 
that they cannot be depended upon, and the main hope is to post- 
pone the fatal hour, which is often possible, and to make the 
patient comfortable while life lasts. Much more depends upon 
hygiene than medicine. Perhaps the most important point, and the 
one least regarded, is the supply of abundance of pure, fresh air. 
Fear is always expressed, lest the patient take cold, and thus the 
impure air is breathed again and again, every avenue being cut off 
by the mistaken kindness of the friends. Daily exercise in the 
open air, properly protected, is the next consideration. This, too, 
is systematically avoided. Proper employment, both of mind and 
body; proper nourishment, at regular intervals, with food highly 
nutritious and of easy digestion; cleanliness, both of the body 
and of the surroundings ; sunlight in abundance ; cheerfulness of 
the attendants; all these are eminently valuable, and contribute 
largely to retard the progress of the disease, while their neglect as 
fully contributes to the rapidity of the downward march. Medi- 
cines can do but little. Cud-liver oil, in fact, all animal fats, aid 
in maintaining the general strength, and retard its rapid decay. 
Iron, quinine, etc., also aid in a variety of ways, as do the remedies 
to soothe the cough and pain, procure rest, etc. Cod-liver oil has 
been employed in a variety of ways, because of the nausea it often 
causes, and with the hope of adding to its efficiency. Thus, it is 
mixed with the froth of malt liquors, or ammonia or salt are added 
to it, to disguise the taste. It is mixed with hydrate of lime, to 
make a soap, or with the lacto-phosphate of lime, iron, etc., to make 
an emulsion. It is combined with the tinctures of columbo, or 
gentian, or cinchona. It is made into bread, or given in gelatin 
capsules. Whisky, brandy, wine, etc., should be used moderately, 
to aid digestion, and never to stimulate, otherwise they add to the 
trouble. They may be given, with most advantage, in the form of 
milk punch, with eggs beaten up in it. Beef and brandy will not do 
any of the many miraculous things anticipated, and should be aban- 
doned. Beef tea is very useful ; it is easy of digestion, and rarely 
proves unacceptable Milk, given in regular quantities, not so 
much at once as to embarrass the digestive powers, is of immense 
value. Koumiss, made by fermenting milk, is claimed, by some, 



Consumption. 167 

to be the real cure, if that be possible, of this disease. The cough 
may be treated by inhalations of the vapor of iodine, made by 
pouring ten to twenty drops of the tincture of iodine in hot water ; 
or the inhalations of cubebs and carbolic acid, and of tar, given, p. 
351. For internal remedies, the receipts Nos. 144, and 155 (p. 
349), will be useful. Nothing, however, which disturbs the diges- 
tion, must be continued. If bleeding of the lungs occurs, rest, 
with perfect quiet, and gallic acid, in ten grain doses, will generally 
check it speedily. Ice, slowly dissolved in the mouth, will be 
useful, though salt is generally the popular remedy. The night 
sweats may be checked by aromatic sulphuric acid, ten drops in a 
wineglass of water, or by bathing the body with alum, dissolved in 
whisky. Diarrhoea may be checked by the vegetable astringents, 
as will hereafter be mentioned. Plasters of belladonna, opium, 
conium, irritation with iodine, croton oil, etc., will be useful for 
the chest pains. Blisters are rarely beneficial, and often exhaust 
the strength. Where it is possible, a change to an equable, dry 
climate would be advisable, but this must be done early, or else it 
is too often changing the place in which to die. 

How Prevented. This is much more important to know than 
how it is treated, for in the prevention of consumption art is strong, 
in its cure very weak. Persons who have a hereditary or other 
tendency to the disease should not inhale an atmosphere loaded with 
smoke or dust. They should choose an outdoor life, and prefer- 
ably, one in the country. Horseback exercise is especially useful to 
them. Sydenham, the great physician, said, "in consumption the 
best doctor is a horse, the best apothecary an ass ;" so much did he 
believe in this exercise. Yet all violent esfertion, as immoderate 
running, dancing, singing, etc., should be avoided. Flannel should 
be worn next the skin at all seasons, the night air generally avoided, 
a salt bath taken every morning, followed by thorough dry-rub- 
bing, and the food be light and nutritious. When practicable, the 
cold winters should be avoided by a change of climate, as a long 
sea voyage. The chest should be expanded by appropriate exer- 
cise, and by the habit of deep and long breathing, several times a 
day. Very much can be done by these means, and often the ten- 
dency to the disease wholly escaped. 



1 68 Diseases of Adults. 

II. Ailments Seated in the Food Passages. 

Dyspepsia, or indigestion, will include gastritis, gastric catarrh, 
gastric ulcer, vomiting of blood, sour stomach, water-brash, heart- 
burn, loss of appetite, and biliousness. 

How Brought On. Indigestion, with its accompanying train of 
discomforts, is the result of haste or carelessness in eating, not 
chewing the food, excess or deficiency of food, fatigue, excitement, 
study, the use of tobacco, or of ardent spirits, and last, but not 
least, the ignorant use of medicine. 

How Distinguished. The most prominent symptom is a feeling 
of uneasiness, not exactly pain, at the stomach. Pain would be 
indicative of ulceration. Nausea, and even vomiting, occasionally 
occur. There is a clammy feeling in the mouth, with a bitterness, 
or sourness. The skin is generally sallow. The bowels are gene- 
rally costive, but this may be alternated by diarrhoea. When bil- 
iousness is present, the stools are apt to be scanty, and of light 
clay color. The following symptoms appear, from time to time: 
water-brash, a running of tasteless fluid from the mouth; heart- 
burn, caused by the presence of acid in the stomach, and extending 
up the oesophagus; palpitation of the heart; headache; depression 
of spirits, melancholy, or the occurrence of foolish ideas ; disorders 
of taste, vision, etc. ; more or less vertigo in every case. Dyspepsia 
is always an obstinate affection, but can scarcely be regarded as dan- 
gerous. 

How Treated. Medicine is less important than the regulation 
of the quantity and quality of food, and the hours for its ingestion. 
Plain, easily digested food, is required. The stomach should never 
be loaded; the meals should not be at too long or too short inter- 
vals. Beef, mutton, fowl, oysters, roasted, stewed, or panned, never 
fried, with bread rather stale; crackers, kiln dried; rice; stewed or 
fresh fruit ; and milk, as a beverage, will be the proper diet for the 
dyspeptic, and will give a sufficient variety. Pastry must be scrupu- 
lously avoided. Some prefer, and may have, milk tea, or milk and 
warm water, as a drink with the meals. Some seem to require a 
slight stimulant with dinner, and here, ginger and water, or cider, 
or sherry wine and water, may be allowed in small quantities. 



Dyspepsia. 169 

Where the digestion is greatly impaired, the food may be given in 
very small quantities, at short intervals. To use the remark of a 
distinguished authority, "sixty meals a day." Of course, this is 
only to be enforced until the stomach will bear a larger quantity at 
■a time, when the plan should be abandoned. Daily exercise, in the 
open air, and bathing, are very important, as well as rest at meal- 
time. Never eat under an excitement. At a meal, the family chat 
aids the digestion; hence the better appetite while traveling; the 
mind is relieved of cares, etc. 

Medicines are required to stimulate the digestive powers, as gen- 
tian, columbo, and ginger (see page 361), in cases of nervous 
debility; iron, when the blood is poor, as the syrup of the iodide, 
or the potassio-tartrate fsee pages 360 and 361). The bowels 
must be kept free by mild laxatives, as the mineral waters, senna, 
rhubarb, magnesia, sulphur; when the constipation is obstinate, 
aloes, or May-apple, may be added. If acidity is present, the bi- 
carbonate of soda, or potassa, the carbonate of magnesia, and the 
aromatic spirits of ammonia, are best. The sulphites are highly 
lauded, as also is charcoal. When the liver is torpid, small doses of 
cream of tartar (p. 340), or dandelion tea (p. 350), will relieve it. 
Many prefer five drops of nitro-muriatic acid, three or four times 
daily, well diluted with water, as a stimulant both of the stomach and 
liver. The other acids, the nitric and hydrochloric, have been 
employed, as also bismuth, which lately seems to have obtained 
great favor. The heart-burn and water-brash are best relieved by 
bicarbonate of soda, ten grains, in water, before eating; when the 
latter is very annoying, astringents may be used, as blackberry tea 
(page 349), tincture of chloride of iron. Hiccough, which is 
often very annoying and distressing, may be controlled by the 
anti-spasmodics, but chloral is perhaps the best remedy for this. 
When blood is vomited, it is not from the lung, if dark and clotted, 
and mixed with food ; this requires rest in the horizontal position, 
ice slowly dissolved in the mouth, and when very abundant, astrin- 
gents, as gallic acid, in ten-grain doses. 

When inflammation or catarrh of the stomach is present, there 
is great pain on pressure over the stomach, vomiting of all ingesta, 
and fever. A bilious attack is the result of indigestion, or expos- 
15 



170 Diseases of Adults. 

ure, and has the same symptoms, with vomiting of greenish fluid, 
which is very acrid, constipation, headache, and vertigo. To relieve 
these attacks will require rest, abstinence from food, ice in small 
quantities, cream of tartar, and May-apple (pp. 340, 341). 

Gastric ulcer, or ulcer of the stomach, is marked by a severe 
sickening pain and tenderness at a particular point, the seat of the 
ulcer. This is aggravated by motion, and by food, especially if it 
be hot. Vomiting is present, and often the ejected matters are 
mixed with blood. This is the special sign of gastric ulcer. The 
diet must be unirritating, lime-water and milk, arrowroot, rice, 
sago, corn starch, tapioca, fresh eggs, beef tea, or mutton broth. 
The healing of the ulcer is aided by subnitrate of bismuth, and 
oxide of zinc, about ten grains of the former, or three of the lat- 
ter, three times a day. To check the incessant vomiting, hypo- 
dermic injections are valuable. 

Colic is known as belly-ache, wind in the bowels, bilious colic, 
cramp colic, and flatulence, and may be produced also by a spasm 
of the stomach, or the passage of gall stones. 

How Brought On. As above noted, it is generally the result of wind 
in the bowels ; or, it may be caused by cramp or spasm of the parts ; 
congestion, produced by exposure, particularly of the feet; or the pas- 
sage of gall stones. Wind in the bowels is the result of indigestion. 
How Distinguished. There are more or less vomiting, pain, 
with exacerbations, distention of the abdomen, constipation, fever 
of slight degree, belching of wind. In the bilious forms, the vom- 
iting is of a greenish-yellow fluid, and may be followed by a slight 
jaundice. The passage of a gall stone is extremely painful ; the 
line of pain can be mapped out by the sufferer, and is chiefly in the 
right side ; sudden relief follows the escape of the stone, though the 
tenderness may continue a while. . It is also believed that one cause 
of pain is the passage of the acrid bile. What is known as lead 
colic, or painter's colic, or " dry belly-ache," is caused by the poison 
of the lead carried into the system ; here the abdomen is shrunken, 
there is no vomiting, the bowels feel as if knotted, the pain is less- 
ened by pressure, hence there is no tenderness ; there is restless- 
ness, with extreme suffering. Generally, a blue margin is observed 
on the gums. 



Colic. 171 

How Treated. The bowels are to be opened, and the pain and 
spasm relieved. When there is reason to suspect a loaded stomach, 
an emetic will be useful, as a tablespoonful of salt, or a teaspoonful 
of mustard, in a cup of warm water, repeated in a few minutes, if 
required. The bowels may be relieved by warm clysters ©f castor 
oil, salt, soap, molasses and water. Magnesia may be given, with 
essence of peppermint, or ginger, as on pages 340, 341. When 
the nausea and pain are great, we may use aromatic spirits of harts- 
horn, spirits of camphor, about twenty drops of either, repeated 
frequently. These failing, or the emergency being great, anodynes 
will be necessary, as chloroform, opium, paregoric etc. (see page 
357). Externally, mustard plasters, or flannels, wrung out of 
hot liquor, hot foot-baths, and the immersion of the abdomen in 
a tub of water as hot as can be borne, will often give immediate 
relief. In many instances, massage, or kneading the abdomen, will 
cause the wind to be dislodged, though this requires too much care 
to be entrusted to inexperienced hands. Care, also, is necessary in 
every case, lest there be a concealed rupture or hernia, and in every 
instance this may be suspected, when the pain is prolonged, and the 
vomiting is of a dark color, and offensive odor. 

The colic of infants is generally readily relieved by some aro- 
matic, as anise or fennel tea, or peppermint candy, dissolved in hot 
water; at the same time, hot applications should be made to the 
stomach; the best is a flannel wrung out of hot whisky or alcohol. 
In more urgent cases, a drop or more of chloroform, added to the 
medicine, and repeated as required, will relieve. The bowels 
should be keep free by mild aperients, as senna, rhubarb, manna. 
Lime-water in the milk will correct acidity. Much of this trouble 
is due to the carelessness of those who have charge of the infant, 
and cram it, even with highly improper food, in place of allowing 
it the proper nourishment, and that only. 

Bilious colic may need, in addition to the remedies already given, 
those specially acting upon the liver, as blue pill, or calomel with 
opium ; podophyllin, taraxacum, nitro-muriatic acid, etc. If inflam- 
matory action appears imminent, leeches or cups may be bene- 
ficially applied over the liver. 

The passage of gall stones may necessitate the use of anaesthesia, 



172 Diseases of Adults. 

to relax the duct leading to the bowels, and to relieve the intense 
agony. Chloroform, internally, is supposed to aid in dissolving 
these concretions, thus supplying a double purpose. 

When gout is transferred to the stomach, the treatment is simi- 
lar, but requires more energetic measures. The duses of chloroform, 
morphia, etc., must be greater, and more frequent. 

Lead colic will require relief of the pain in the same way, and 
antidotes for the poison. Iodide of potassium is perhaps the best, 
ten grains, three times a day, combined with a diet exclusively of 
milk. (See " Lead Poisoning.") 

Constipation, or costiveness, will result from obstruction of the 
bowels, a knot, congestion, and will often be accompanied by vom- 
iting of foul matters. Under this head we may consider typhlitis, 
or inflammation of the lower bowel. 

How Brought On. This is generally the result of neglect of 
the bowels, indigestion, want of exercise, but may occur from strict- 
ure, or some mechanical obstruction. 

How Dtstlnyulslied. In the aged, or those otherwise diseased, 
the presence of palsy of the bowels, or of stricture, etc., may be 
feared, particularly when a hard, painful lump is felt at one point. 
Here, the costiveness is very persistent, there is vomiting of mat- 
ters which should pass downward, with cold skin, prostration, great 
mental distress, and collapse. At the affected point, everything 
stops, wind accumulates and swells the abdomen. 

How Treated. Much depends upon care and diet. The latter 
should be of a laxative nature: stewed and fresh fruit, molasses, 
bran bread, rye mush; with many, oat meal mush, for supper, acts 
as a laxative. Next, a very important matter is to have a particu- 
lar time to attend to this necessity, and soon it becomes a fixed 
habit. Proper exercise, and kneading of the bowels, also act to aid 
in the relief of the torpid condition. 

When medicine is used, it must be as mild as will serve the pur- 
pose: rhubarb, podophyllin, senna, and injections of warm water, 
or of soap, molasses, salt, etc. Many are readily relieved by sup- 
positories of soap. The natural laxative mineral waters may be 
used with excellent results. Electricity is also useful. (See pages 
340 and 341, for prescriptions.) 



Diarrhoea. 173 

Typhlitis is an inflammation of a portion of the lower bowel. 
It has all the symptoms of constipation, with fever, pain at a fixed 
spot, swelling of the abdomen, vomiting, and shortly diarrhoea, 
which may be mucous, bloody, or filled with matter or pus. 

Bleeding will be necessary, especially in the robust. Leeches 
should be applied to the affected spot, and their action aided by 
poultices of flaxseed, hops, Indian meal, etc. Anodynes are about 
the only remedies that can be useful. The food must be mild and 
soft, or fluid, as sago, arrowroot, beef tea, etc. It may end in an 
abscess, and death from its rupture into. the cavity of the abdomen. 

Diarrhoea, or looseness of the bowels, summer complaint, may 
be acute, sudden, or chronic, persisting. 

How Brought On. This disease may result from improper food, 
as too much or unripe fruit, decayed vegetables, bad water, cold, etc. 

How Distinguished. It is marked by too frequent and profuse 
discharges from the bowels, with more or less pain ; the discharges 
may be bilious, thin, and watery, of a dirty, ill-smelling water, mu- 
cous, or "rice water," as in cholera. 

How Treated. Rest, in the horizontal position, will, in very many 
instances, check the disease in its incipiency. In every case this is 
important, and greatly aids the treatment. When the symptoms are 
not urgent, the discharge should not be checked suddenly, as it 
often marks the crisis or passing off of a disease. It appears as 
though the system were thus throwing off the cause, or poison. 
Especially is this true in typhoid fever. When acidify is present, 
antacids, as lime water, or solution of soda, are requisite. Blue 
pill, mercury with chalk, charcoal, magnesia, these may be given in 
the aromatic syrup of rhubarb, or with syrup of ginger, or cinna- 
mon water. Astringents are necessary when these fail, and here 
we have blackberry root tea, logwood tea (p. 348), white oak bark 
tea (p. 349), and the like. For pain, and also to aid the other 
remedies, paregoric, or calamus (p. 350), may be added. When 
the disease is persistent, oxide of zinc, especially for children, is 
excellent. About five grains are a dose. In chronic cases, acetate 
of lead, or tannin with opium, say two or three grains of lead to 
a half grain opium, or three grains of tannin, with the opium, every 
three, four, or five hours. Enemas of the same, in solution, will 
15* 



174 Diseases of Adults. 

also be very efficient. The use of fruit and vegetables must be 
prohibited, and the diet must be regulated so as to avoid any irri- 
tation of the bowels. 

Dysentery, or bloody flux, or bloody stools, is an inflammation 
of the large bowel, the colon, hence it is also called colitis. 

How Brought On. This disease appears to occur most fre- 
quently about the last of August and September, and is due to the 
use of unripe fruit, improper food, exposure to cold and damp after 
the heat of the day, impure water, etc. It often prevails in a local- 
ity as an epidemic, attacking the majority of those exposed to it. 

How Distinguished. It is characterized by pain in the lower 
part of the abdomen; tenderness on motion and on pressure; fre- 
quent desire to evacuate the bowels; small, bloody, mucous passages; 
great tendency to strain or bear down, which is called "tenesmus;" 
griping, called "tormina," and moderate fever. There may be 
debility, generally not at first; ulceration, and purulent, shreddy 
discharges may occur later. 

How Treated. Where the strength will bear it, and the inflam- 
mation is great, leeches may be usefully applied, at first, to the 
abdomen, at the seat of the greatest soreness, followed by warm 
poultices of flaxseed, hops, Indian meal. A tablcspoonful of castor 
oil, with fifteen to twenty drops of laudanum, is the usual dose 
before anything else, and this is generally very useful. A large 
injection of warm water is often of great service. Alteratives, as 
blue pill with ipecacuanha, camphor, or opium, are next in order; 
then acetate of lead and opium (as under Diarrhoea*), to complete 
the cure, if it has not already been accomplished. As in diarrhoea, 
rest, in the horizontal position, is very important, and aids greatly in 
the early relief of the patient. 

Of course, great care should be paid to the diet, which should 
be mainly of rice, arrowroot, chicken or beef tea ; and for the 
thirst, iced drinks, as slippery elm water, gum arabic water, etc. (p. 
322). Enemas of iced water are very soothing, or of flaxseed tea, 
with a half teaspoonful of laudanum (p. 350), or starch and laud- 
anum, or acetate of lead and laudanum, in starch, in the same pro- 
portion. 

With great debility, quinine may be given, or other tonics (see 



Cholera. 175 

p. 360), and even stimulants, if there is great weakness. Nitric 
acid, in the form known as Hope's Dysentery Mixture, that is, one 
fluid drachm nitric acid, forty drops tincture of opium, eight fluid 
ounces camphor water, in tablespoonful doses, every three or four 
hours. Sulphate of soda, or of magnesia, with laudanum, has 
proved useful with some. ' 

How Prevented. Dysentery can generally be prevented by using 
great discretion in diet, avoiding all unripe fruit, all dishes which 
lead to dyspepsia, all irregularities of life, and exposure to cold, wet, 
and night air. A flannel bandage, a foot wide, should be worn 
around the abdomen. Often a spell of constipation precedes dysen- 
tery. Hence, in the late summer and early fall, particular attention 
should be given to having a full passage every day. Diet is gener- 
ally sufficient for this. If not, use cream of tartar (p. 340), some 
laxative mineral water, a seidlitz powder (p. 341), or an injection 
of warm water. 

Cholera. Known as Asiatic cholera, or cholera asphyxia, In- 
dian cholera, epidemic or malignant cholera, and the occasional 
solitary cases of cholera morbus. Bilious cholera must next be con- 
sidered. 

How Brought On. Cholera morbus, or bilious cholera, occurs 
every summer, to a greater or less extent, though in certain seasons 
it is extremely prevalent, and is due to the use of unripe fruit, 
improper food, excesses, cold, etc. 

True cholera is the result of a certain influence which is suscep- 
tible of change of locality, and which may affect the system and 
produce its characteristic symptoms by inhalation, by its contami- 
nation of the drinking water. It never has shown itself to be 
contagious. It would appear, most frequently, to have found its 
nest in accumulations of putrefying animal matter. 

How Distinguished. It is generally preceded by a painless 
watery diarrhoea, called cholerine, though its attack may be extremely 
sudden, and all the worst symptoms develop with lightning-like 
rapidity. The diarrhoea may last from a few hours to three days, 
increasing in its frequency, and soon accompanied by vomiting and 
pain. The fluid discharged, both from the bowels and the stomach, 
is a colorless water, familiarly termed "rice-water discharges." 



176 Diseases of Adults. 

Cramps in the limbs ensue, with great prostration, cold skin, intense 
thirst, hoarseness, or loss of voice, loss of pulse, profuse sweating, 
blueness of the skin, the fingers become shriveled like those of a 
"washwoman," hence the term "washerwoman's fingers," the nose 
pinched, the breath cold, collapse comes on, and death closes the 
scene. If reaction occurs, it may be followed by a low fever, or 
the case may go on steadily to recovery. Cases of summer cholera 
rarely present all these symptoms, while cholera morbus has only 
the cramps, vomiting and purging, never the peculiar discharges, 
and almost invariably rapidly recovers under the appropriate treat- 
ment. 

How Treated. The treatment is almost as varied as the number 
of observers, and in malignant attacks everything fails. The treat- 
ment undoubtedly must be greatly antispasmodic, and chloroform 
has shown its power in this respect. The diarrhoea, which is all 
the more dangerous, as it is painless, should be checked by the reme- 
dies given above. Particularly should rest be enjoined. The 
remedies, as paregoric, ginger, lavender, aromatic spirits of harts- 
horn, act by soothing and stimulating the system. If vomiting 
sets in, mustard to the abdomen and to the feet, or, if there is rea- 
son to suspect the presence of any offending matter in the stomach, 
great good has resulted from a draught of salt and hot water, a 
teaspoonful of salt in a tumbler of hot water. In repeated instances 
this has acted very promptly, and particularly while waiting for 
other and more powerful means. When the cramps, etc., have 
fully set in, the best and surest means is the administration of chloro- 
form and aromatic spirits of ammonia, in full doses, frequently 
repeated. An excellent formula is : two fluid drachms chloroform ; 
one-half fluid ounce each compound tincture of cardamom and 
paregoric ; one and a half fluid ounces each syrup of ginger and 
mucilage of gum acacia; mix well. The dose would be a teaspoon- 
ful, followed by a lump of ice; repeated every ten or fifteen minutes, 
or even oftener, until relief is obtained. Of course, this will serve 
as an example, and may be modified by additions, or change of 
dose, as occasion demands. The use of stimulants will be necessary, 
both by the mouth and by frictions, to promote the flow of the 
blood, and produce reaction. In collapse, every remedy must be 



Cholera. 1 77 

increased. A variety of remedies are offered, some of which we 
shall enumerate: hot mustard, or salt baths (p. 337), warm baths 
of infusion of stramonium leaves, chloral, in large doses, hot ene- 
mas, the warm bath, with carbonate of ammonia, chloroform by 
inhalation, etc. 

Perhaps the best treatment of cholera is that known as the acid 
treatment. In the report on the subject of cholera, by the U. S. 
War Department, through the Surgeon General, this treatment is 
shown to be extremely successful, both as a cure and as a prevent- 
ive. As a preventive, and as a remedy in every stage, it is given 
as sulphuric acid lemonade, to fill the system, as it were, with acid. 
Twenty drops of dilute sulphuric acid are mixed with four ounces 
of water, and sweetened. This is to be used freely, as a beverage, 
by the patient, attendants, and all exposed. By this plan, the mor- 
tality has been reduced to 8 deaths in 100 cases. It acts also as a 
prophylactic, by allaying the fears, and thus those exposed are less 
liable to an attack. Given in the same way to a patient, it relieves 
the nausea and vomiting, and the passages are gradually checked. 
The acid appears to act by killing the cause of the disease. 

How Prevented. Cholera must be prevented by vigorous hy- 
gienic measures. All infected goods, cloths, etc., must be destroyed 
by burning, or thoroughly washed, dried, and disinfected, by acids 
in some form, as acidulated water, or acid gases. No diarrhoea can 
be regarded as harmless during a season of cholera. The ejecta 
must all be disinfected and kept from contact with other patients, 
their clothing, or any of their surroundings. Every vessel must 
be treated rigorously when even one case occurs on board of it, and 
thus render quarantine restraint unnecessary. Attention should be 
directed to the condition of each house and its premises, that there 
is the most thorough cleansing, ventilation, and disinfection ; to the 
drainage of every town ; in short, cleanliness, ventilation, and disin- 
fection, will prevent this disease, and nothing else can do it so 
effectually ; but it must be by visitation from house to house that 
the authorities can know that this has been effectually accomplished. 

Jaundice may be called yellow, green, or black jaundice, though 
these are quite improper, as the word jaundiced means a yellowish 



1/8 Diseases of Adults. 

condition. It may be caused by liver disease, torpidity of the liver, 
ulceration, etc. 

How Brought On. It is produced by any disease or mechani- 
cal obstruction which prevents the removal of the bile from its 
place of formation to the bowels ; and thus it is taken up again into 
the blood, and distributed to the skin, the eyes, etc. It may be 
due to exposure to cold and dampness, to violent emotion, to preg- 
nancy, to malaria, etc. 

How Distinguished. It may be suddenly, or, after general lan- 
guor, debility, etc., that the whites of the eyes are observed to be 
tinged with yellow, the routs of the nails, the face, and gradually 
the whole surface of the body. The urine has a more yellow 
appearance, and stains everything yellow, but the passages from the 
bowels are wanting in their natural appearance, being sometimes 
of a dull white, lead color, or a very light brown. The tongue is 
coated, and there is an acrid taste. The general system synipa- 
thiz •> ; there is debility, with great depression of spirits, or melan- 
choly. 

How Treated. Unless an obstruction is known to exist, the 
remedies should be such as act on the liver. These are known as 
cholagogues. But moderate efFects should be induced at first, 
hence small doses of cream of tartar, or of May-apple, as given, 
pages 340, 341. Sometimes three grains of blue pill acts very 
well. It should be followed by a purgative. Salines are best, as 
the citrate of magnesia, cream of tartar, etc. If the case seem 
obstinate, the cholatro'_ r ues may be repeated, in small doses, at fre- 
quent intervals. Extract of dandelion, or dandelion tea (p. 350), 
or nitro-muriatic acid, five drops in a wineglassful of water, are best 
to continue the action, and promote the absorption of the effused 
bile. Ether and chloroform are supposed to act as solvents of gall 
stones, and hence are given in cases supposed to result from the 
presence of such obstructions. A teaspoonful of ether, in a tum- 
bler of water, three times a day, may be taken. 

Piles, or hemorrhoids, are small tumors or pouches filled with 
blood, at the edge of the bowel, or just within it. Hence, they 
are outward or inward, or they are bleedins, or blind, dry piles. 

How Brought On. They are caused by anything which acts to 



Piles. 179 

cause a flow of blood to the lower bowel, or which tends to obstruct 
its return. They are generally most frequently seen in the ple- 
thoric, those of sedentary habits, in pregnancy, or in those much 
troubled with diarrhoea, or dysentery, or the reverse, constipation. 

How Distinguished. Back-ache is so commonly the result of 
piles, that their presence should always be suspected when this is 
much complained of. They are characterized by fullness and weight 
in the lower bowel, soreness, pain after a passage, and which may 
extend down the limbs and to the loins. When inflammation occurs, 
the aching and throbbing are intense. At every passage, there is 
felt the presence of something which will not come away, as though 
the stool was not completed. When they are outward, examination 
reveals the presence of one or more tumors, more or less painful. 
When within, blood, and the above symptoms with the passages, 
indicate their presence, or the piles may be forced out, and appear 
as a hard painful mass, which often must be forced back by the 
hands. The pain is great until it is returned, and the constriction 
is thus removed. While the bleeding is generally small, in some 
cases large amounts of blood are lost, and generally the patient who 
has suffered long shows a blanched appearance, and is affected with 
poverty of the blood. 

How Treated. Special attention must be paid to the avoidance 
of any action of the bowels liable to cause or increase the flow of 
blood to the parts. Costiveness, especially, must be relieved, while 
diarrhoea, etc., are checked. Diet will have much to do with this, 
and it should be of food easily digested, and not exciting. Seden- 
tary occupation, fatigue, standing too long, whatever tends to irri- 
tate the parts, or cause a flow of blood there, must be avoided. 
Soothing ointments, and the same containing astringents, will act 
well in relieving the trouble. After each stool, the parts should be 
bathed with cold water, or cold alum water, a teaspoonful of pow- 
dered alum to a pint, or the sal ammoniac wash (p. 355), and an- 
ointed with tannin ointment (p. 356), or other. Mild laxatives, as 
stewed fruit eaten freely, senna, rhubarb, sulphur, will be indicated, 
and the careful avoidance of irritating purgatives. The parts, when 
gorged with blood, may be unloaded by leeches, and cups to the 
lower part of the back. When the bleeding is too free, it must be 



180 Diseases of Adults. 

checked by subsulphate of iron, alum, cold water, ice, etc., applied 
freely to the parts, and by carefully preserving the horizontal posi- 
tion. When the piles extrude, as after a passage, they must be 
carefully anointed and replaced. One of the best applications is 
the following. A epiantity, the size of a small pea, to be gently 
applied after each stool : 

PILE OINTMENT. 

Dried Persulphate of Iron, half a drachm. 

Powdered Opium, one scruple. 

Washed Unsalted Lard, one ounce. 
Rub them well together. 

A body bandage, continually worn, often gives great relief. When 
all fails, the tumors must be cut off. 

Fistula of the Anus, or fissure, will present very similar symp- 
toms, but examination shows a crack, or fissure, in the bowel, at 
the opening; or, when a fistula, there will be a false passage, or a 
small opening, into which a portion of the stools will pass and be 
retained. Generally, surgical treatment is necessary, but often, by 
the use of soothing ointments, as belladonna, oxide of zinc (p. 356), 
lead, or touching the part with nitrate of silver, will cause it to 
heal. To relieve pain, opium, belladonna, etc., made into supposi- 
tories with cocoa butter, will be useful. 



III. Ailments Affecting the Blood Passages. 

Heart Disease will include palpitation, fluttering of the heart, 
pain in the heart, angina, rheumatism or neuralgia, dropsy, heart- 
break or rupture, and fatty heart. 

How Brought On. Heart affections, or symptoms, may be 
caused by dyspepsia; by inflammation; by transfer of disease, as 
gout, or rheumatism, to the heart; by great emotion; by age, or 
debility from any cause. 

How Distinguished. Heart disease is either an affection of this 
organ itself, directly, or by irritation by, or sympathy with, an 
affection of another organ. When the heart itself is diseased, there 
are irregularity of the pulse and of the beats of the heart, general 



Heart Disease. 1 8 1 

uneasiness, as by sympathy of the whole system, more or less pain, 
occasional coldness of the extremities, and lividity or suffusion of 
the head and face, brain trouble, as vertigo, fullness, etc. On lis- 
tening to the heart, with the ear placed over it, the sounds will be 
unnatural, the beat will be heard irregularly, there will be a blow- 
ing or a hissing sound, a rubbing sound, or the beats will vary by 
being too feeble or given with too great force. These symptoms 
will show disease of the heart, as hypertrophy, or enlargement, 
atrophy, or diminution, dilatation, disease of the valves. But when 
there are palpitation, throbbing, irregular beats, without these 
sounds, th in the affection will most likely depend upon poverty of 
the blood, or anaemia, which will be further shown by the other 
general symptoms of that condition, as detailed in a previous chap- 
ter; or these symptoms will follow a full meal, an evidence of their 
being the result of indigestion. Neuralgia, or angina pectoris, 
rheumatism, or gout of the heart, are shown by the intense, ago- 
nizing pain in the heart ; in the first case, this pain shoots down the 
left arm ; in the latter, there are the general symptoms of gout or 
rheumatism elsewhere, and a sudden cessation of the attack, and 
its equally sudden appearance in the heart. 

Heart-break, or rupture of the heart, would result in sudden 
death after great mental emotion, and could only be known by a 
post-mortem examination. Though rare, it has been known to 
occur. Dropsy of the heart would be shown by the sounds of the 
heart being muffled, and the noise of fluid around the heart. Fatty 
heart may be surmised to exist when the patient has feeble, irregu- 
lar action of the heart, when there is general evidence of a break- 
ing down of the system, but can only be known by the examina- 
tion after death. When sudden death occurs, it may be regarded 
as most probably due to heart disease, when it has been preceded 
by sudden difficulty of breathing, great and sudden paleness, a flut- 
tering pulse, and pain in the region of the heart. 

How Treated. Great pain in the heart, from whatever cause, 
demands immediate relief. This may be given by opiates, chloral, 
the inhalation of nitrite of amyl. Combined with these must be 
the most perfect quiescence in the horizontal position, with the 
head but slightly raised. To relieve the great debility accompany- 

16 



1 82 Diseases of Adults. 

ing heart disease, stimulants are requisite, but they must be given 
with great care, lest they further excite the heart. When the 
heart's action is too rapid, it may be controlled by digitalis, and 
preferably, the tincture. This remedy may be given twenty or 
thirty drops at a time, in repeated doses, every three or four hours, 
watching its effects, and as the pulsations are reduced in force and 
frequency, it may be lessened in dose, or omitted. Often, this fre- 
quency of action is combined with feebleness, the irregularity being 
due to thinness or poverty of the blood ; here, the indication is to 
unite the digitalis with iron, as the tincture of tbe chloride of iron, 
ten drops, or the potassio-tartrate of iron (p. 361). In all cases 
of syncope, or fainting, the patient should be placed with the head 
lower than the body, so as to cause the blood to flow into the brain, 
and thus arouse it to its duty. Too long a faint will permit the 
formation of a clot in the heart, which at any moment may cause 
sudden death. Where evidences exist of inflammation of the 
heart, this must be met by bleeding, leeches and cups over the 
heart, free purging, and the use of the tincture of veratrum viride, 
ten or fifteen drops, to quiet the heart's action. If of rheumatic 
origin, the treatment appropriate to that affection must be employed. 
If dropsy result, the fluid must be evacuated as rapidly as possible, 
by the use of diuretics, as sweet spirits of nitre, squills, junipei 
berry tea, brisk purgatives, etc. All emotion must be sedulously 
avoided. The diet should be of a tonic and easily digestible nature. 
When heart trouble is caused by indigestion, the former is relieved 
by those remedies calculated to relieve dyspepsia, as detailed in the 
chapter upon that subject. Exercise in the open air, when taken in 
moderation, will always be beneficial in heart disease. 

How Prevented. All tendency to heart affections require fresh 
air, moderate exercise, the avoidance of excitement, easily digested 
diet. 

Swelling of the Arteries, or aneurism, is the formation of a 
tumor on a part of an artery, by reason of a rupture of one of the 
coats of the vessel, or a general softening of the vessel, causing it 
to give way, and swell irregularly. 

Eoio Brought On. This is generally the result of an injury, 
as a blow on the part, a strain, etc., or it may be due to general dis- 



Swelling of the Arteries. 183 

ease of the artery, causing its coats to become softened, and lose 
their power of resisting the force of the current of blood. Rowing, 
boxing, and running, most frequently cause aneurisms, especially of 
the vessels of the arms and legs, as also of the larger vessels directly 
connected with the head. 

How Distinguished. An aneurism, wherever located, is char- 
acterized by a swelling or lump, appearing rather suddenly, without 
any of the peculiar signs of inflammation, as redness, heat, etc. 
The tumor is always situated on one of the arteries, which may be 
felt extending from it on either side ; it is soft, yielding, but elastic ; 
has but little, if any pain, and is always attended with a pulsatile 
movement. Compression on the heart side of the tumor will cut 
off this movement, and cause a sensible lessening of the enlarge- 
ment. In distinction from an enlarged gland, the aneurism is fixed, 
the gland more or less movable. Aneurism generally develops 
slowly. When situated in the large vessel near the heart, the aorta, 
it gradually causes a bulging of the chest, and often produces diffi- 
culty of breathing, pain at the spot, cough, loss of voice, and even 
interferes with swallowing. These complications are the result of 
pressure upon the parts surrounding the tumor. When it occurs 
lower down, as in the abdomen, there is deep-seated pain in the 
back and abdomen, no fever, and all treatment fails to have any 
effect. In every instance, the pulsation of the tumor is a marked 
symptom. 

How Treated. Surgical interference is necessary for the com- 
plete cure of aneurism. In those occurring in the smaller vessels, 
this is all, but when this affection takes place in the larger arteries, 
as those of the chest, or abdomen, much aid and comfort may be 
derived from hygienic measures. It should be remembered that 
death may suddenly occur, and for this the patient should be pre- 
pared. All excitement should be sedulously avoided. Exertion 
should be limited to the lightest exercise. The food should be such 
as will be easily digested, so as to avoid any troubles with the 
stomach, etc. The stomach should not be loaded with food. The 
surroundings should be guarded, so as to avoid the possibility of 
annoyance, by much company, by business, or by household cares 
and vexations. By forcibly impressing upon the minds of the 



184 Diseases of Adults. 

attendants the vast importance of these points, much may he done 
to prolong life and avert the fatal rupture of the tumor. The vol- 
ume of blood may be lessened by limiting the amount of fluid taken 
into the system, and this reduces the pressure upon the sac. 

IV. Ailments Affecting the "Waste Passages. 

Kidney Diseases will include inflammation of these organs, 
Bright's disease, Addison's disease, gravel, or kidney stone. 

Inflammation and Congestion. Mow Brought On. The 
kidneys may be congested, either from inflammation, irritating medi- 
cines, cold, etc., which induces the active form of congestion ; or, 
as a result of obstruction which prevents the return of blood from 
the vessels of the kidneys, which causes the passive form. 

Mow Distinguished. This trouble is recognized by pain in the 
lower back, and tenderness on pressure over the kidneys. The 
urine is scanty, of high color, occasionally bloody. By boiling it 
in a spoon over a lamp, coagulation occurs, showing the presence of 
albumen. When inflammation is present, all these symptoms are 
seen, but in a greatly aggravated form, and with high fever, followed 
by the discharge of matter or pus with the urine ; before the pus 
commences to come away, there is generally a bulging observed in 
the region of the inflamed kidney, which disappears as the matter 



Mow Treated. The treatment must be directed to the relief of 
the congested condition, or the subduing of the inflammation, which 
is best met by free cupping or leeching, over the seat of pain; pur- 
ging actively, and the use of warm hip-baths. The diet should bo 
mild, and the drinks of a soothing nature, as slippery elm mucilage, 
or flaxseed tea (p. 350), or tea made of quince seeds. 

Bright's Disease is such a state of the kidneys as causes the 
presence of albumen in the urine, and general dropsy. It is, to 
some extent, a breaking down of the structure of the kidneys. 

Mow Brought On. This disease presents in two forms: the 
acute, or rapid, and the chronic, or slow form. Generally, it is the 
result of exposure to cold or damp ; as after scarlet fever, or during 
a debauch, or pregnancy. By some, it is believed to result from 



Bright 's Disease. 185 

ague poisoning, and also from intemperance in alcoholic drinks. 
The slow form is the result of these causes, but often follows a long 
continuance of intemperate habits, or heart disease, and seems also 
due to certain climates. 

How Distinguished. In the quick form, the patient has a chill, 
headache, sick stomach, backache, and pains in the limbs, dry, 
harsh skin, and difficulty of breathing. Then fever sets in, and 
dropsy follows, so that the face, the limbs, in fact, the whole surface 
is puffed up. The flow of urine is almost entirely checked ; what 
is passed is dark, and filled with blood, acid, and is found to be full 
of albumen. The patient is constantly tormented with a desire to 
pass the water. After a week, or even a month, recovery com- 
mences, or the attack becomes of the chronic form, or the poisoning 
of the blood is so great as to cause death. 

In the slow or chronic form, the presence of the disease is often 
not known until too late to check the downward career. The face 
becomes pale, the breathing is short, the strength is easily exhausted, 
and the bladder requires to be emptied frequently. When the urine 
is passed, it is observed to form bubbles on the top, due to the pres- 
ence of albumen, which may be demonstrated by boiling, as before 
mentioned. Suddenly, a convulsion occurs, the sight fails, dropsy 
shows itself, diarrhoea comes on, and every symptom is present of 
the system breaking down. Generally, these symptoms appear to 
improve occasionally, but these appearances are deceitful, and all 
are apt to come back with increased force, ending in convulsions, 
coma, and death. These symptoms may extend over a period of 
years, but generally, a few months ends the scene. 

How Treated. In the acute form, active medication is required. 
The loins may be cupped or leeched, or the trouble may be relieved 
by the use of the hot hip-bath; by active purgation, and particu- 
larly by the use of diuretics, as the citrate of magnesia, jalap, and 
cream of tartar, bitter-sweet tea, uva ursi tea, etc. (see pp. 341 
and 348). The diet, as in all these affections, must be of a liquid, 
nourishing .form. When the chronic form occurs, great care is 
requisite. Cold and dampness must be carefully avoided; the 
strength preserved; little exercise, for fear of fatigue; liquors of 
all kinds must be forbidden ; the skin should be enabled to do its 
16* 



1 86 Diseases of Adults. 

full duty by warm bathing and dry rubbing ; the bowels should be 
kept in a moderately loose condition, constipation carefully pre- 
vented. The diet, as before, should be of a bland nature. For 
this reason, it has been proposed to use exclusively a diet of skimmed 
milk, given in small quantities, frequently repeated, say two or three 
wineglassfuls every two or three hours. As a tonic, iron in some 
form is always best, and chiefly the muriated tincture of iron, ten 
drops in water, after each meal. When the stomach is not too irri- 
table, cod-liver oil is useful to help repair the waste of the system. 
The dropsy becomes a matter of great annoyance, and its presence 
is always alarming. To relieve this symptom, the same medication 
will be useful as in the acute form. The cream of tartar and jalap 
may be given freely, in infusion of juniper berries, broom, etc.; 
and efforts should be made to cause free perspiration, as by the hot 
bath, or the hot air bath. Of course, other diuretics, such as 
given in receipts Nos. 146, 147, and 157, may also be used with 
advantage. 

Addison's Disease is a singular affection, which is characterized 
by bronzing of the skin, weakness, poverty of the blood, irregular- 
ity of the heart, shortness of breath after the slightest exercise, 
inability to digest the food, nausea, vomiting, and impairment of 
vision. It is due to an affection of what are known as the supra- 
renal capsules, small bodies situated upon the top of the kidney.-. 
It generally occurs in young men, and may last for years, always 
ending in death. It may terminate very gradually, by diarrhoea, 
stupor, etc.. or convulsions may come on and end in death. 

How Treated. The treatment is almost nothing. Care, fresh 
air, light exercise, and mild tonics may serve to prolong life. It 
has been thought that good has resulted from a mixture of the tinc- 
ture of iron, chloroform, and glycerine, say fifteen drops of each of 
the first two, with two drachms of the last, this amount to be taken 
two or three times a day. 

Gravel, or Kidney Stone, is also known as lithiasis. 

How Brought On. This affection is supposed to be due almost 
solely to the use of lime-stone water, and hence it prevails much 
more frequently in certain localities. 

How Distinguished. The urine is filled with small stones, or 



Inflammation of the Bladder. 187 

sand ; there is pain in the back, in the region of the kidneys ; the 
attack is generally ushered in by a chill and fever, and more or less 
indigestion ; occasionally, there is great pain, as in the passage of the 
larger particles. The desire to pass the urine is very annoying, and 
there is observed a sediment or deposit at the bottom of the vessel. 

How Treated. As there is always acidity of the urine, this 
must be corrected by the free use of alkalies, and the pain and irri- 
tation relieved by free use of soothing drinks, of flaxseed, slippery 
elm, etc., with sweet spirits of nitre, bicarbonate of soda, etc. 
Should the pain be very great, opium, or preferably, chloral, may 
be given in proper quantities. 

How Prevented. It is deemed possible to prevent these attacks 
by the use of food, mostly of a vegetable form, the avoidance of 
stimulants, the free use of water, or other diluent chinks, exercise 
in the open air, encouraging perspiration, and the use of antacids, 
as Saratoga or Vichy mineral waters. 

Diseases of the Bladder will include inflammation, weakness, 
stone, and bloody urine. 

Inflammation of the Bladder is known as cystitis, or catarrh 
of the bladder. 

How Brought On. This may result from injuries, stone or 
gravel in the bladder, irritating medicines, foul urine long retained. 

How Distinguished. There are pain in the region of the blad- 
der, a constant desire to pass the water, burning or scalding in the 
passage, and a tendency to bear down. More or less fever and 
chilliness are always present. Occasionally, the tenderness on pres- 
sure over the bladder is very great. 

These symptoms may be greatly aggravated, and accompanied 
with sick stomach, mental depression, cold sweats, and delirium. 
The urine may be bloody, filled with matter, or horribly offensive. 
Sometimes there is great difficulty in passing the water. 

How Treated. The patient must be kept quiet in bed, and the 
parts freely cupped or leeched ; warm hip-baths will be found of 
great value (p. 338). If necessary, mild purgation may be in 
duced, as by castor oil, or some similar article (p. 340). To 
relieve the bearing down, heat and pain, pieces of ice may be passed 
into the bowel, and this will be found a source of great comfort to 



1 88 Diseases of Adults. 

the patient. The drinks must be soothing in form, as flaxseed, or 
slippery elm tea. Excessive pain and restlessness may be readily 
controlled by chloral (p. 357), or by suppositories or enemas of 
laudanum or opium. 

St®ne, or calculus in the bladder, would be indicated by sudden 
stoppage of the stream in urinating; pain in the bladder, more or 
less acute; but could only be positively known by the use of a 
sound passed into the bladder and striking the foreign body. A 
prominent symptom, especially in children, is itching or pain at the 
end of the penis, causing the cbild to be constantly pulling at or 
rubbing the organ. This sometimes causes an elongation of the 
foreskin, and great annoyance by the collection of the secretions in 
this part. 

How Treated. The removal of the stone by an operation, 
either cutting or crashing, is almost all that can be done. A vege- 
table diet should be preferred, and the bowels and kidneys kept in 
prompt action. 

Bloody Urine may be the result of injuries; the presence of a 
stone, with sharp edges or points; a strain, causing the rapture of 
a small vessel ; or from inflammation, etc. It is seen in cancer, 
scarlet fever, in the aged, or may result from the use of turpentine 
or cantharides. 

How Trailed. When the blood is mixed with the water, it is 
almost sure to be from the kidneys; when it appears to follow the 
urine, it is from the bladder. When an instrument has been used, 
and it follows cither in a stream or drops, it is from the passage 
itself, and most likely has been caused by an injury, llest in the 
recumbent position is of great importance; astringents must be 
employed to check the hemorrhage, and the best is gallic acid, in 
doses of ten grains, or the muriated tincture of iron, or powdered 
alum, ten or fifteen grains; or some of these may be injected into 
the bladder in free" dilution. - If it is from the passage, and alarm- 
ing, this may be readily stopped by passing the catheter, and com- 
pressing the parts around it until the hemorrhage is checked. 
When the instrument is withdrawn, which should not be until time 
has been allowed for the obstruction of the torn vessel by coagu- 
lum, it should be done with great caution. 



Diabetes. 1 89 

D ia betes , or an immoderate flow of urine, may be sugary diabetes, 
or simple diabetes. 

How Brought On. This disease is caused by injuries to the 
head; the abuse of alcoholic liquors; exposure to cold and damp- 
ness ; sudden checking of the perspiration ; emotion ; fevers ; diseases 
of the brain and spine ; and in the sugary form, the inordinate use 
of food containing sugar. 

How Distinguished. The simple form, or diabetes insipidus, 
generally comes on suddenly, and the patient finds himself con- 
stantly passing his water, and on each occasion a large quantity, 
amounting to many quarts each day. The thirst is intense, and 
the patient drinks immoderately, both day and night, being compelled 
to rise frequently to urinate, and also to quench his thirst. He 
becomes weak and thin, with a harsh, dry skin. 

The sugary form, or diabetes mellitus, usually comes on more 
slowly, and is attended with general languor, uneasiness, emacia- 
tion ; gradually the desire to pass the urine becomes very frequent, 
and the amount becomes alarming, accompanied with great thirst, 
and often with a voracious appetite. The symptoms are similar to 
the other form, the general powers fail, hectic sets in, dropsy of the 
limbs, diarrhoea, the lungs become involved, and death closes the 
scene. m 

How Treated. The treatment of this affection is yet, to a great 
degree, a matter of uncertainty. It is believed that the absolute 
prohibition of sugar in the diet, or of articles prone to form sugar, 
will aid greatly in checking this disease. Hence, the diet must be 
composed of meats, eggs, butter, bran-bread, cabbage, onions, celery > 
lettuce, spinach ; and these must be varied by turns, lest distaste 
occur, and thus an additional cause of debility be induced. The 
forbidden fruits would be, all fruits, wheat bread, potatoes, beets, 
milk, liver, sweet breads, etc. Liquors must only be allowed in 
case of great debility, and then only in small quantities, preferring 
whisky, or sherry or claret wine. 

A great variety of medicines have been proposed, but few seem 
especially useful. Cod-liver oil, both by the mouth and by inunc- 
tion, may prevent the rapid progress of the debility. Perhaps the 
best results obtained have followed the " skim-milk treatment." The 



190 Diseases of Adults. 

patient is restricted to the milk, carefully skimmed, for a month at 
least, and then allowed, in addition, two to four pints of curd made 
by the use of rennets, gradually; as improvement occurs, lean 
meat and green vegetables are given, then eggs, fish, fowl, etc. If 
recovery occurs, substances containing sugar and starch should not 
be allowed for a very long time, if at all. There is always a loss of 
weight for the first few weeks, after which improvement commences. 
In some instances, the "condensed milk" has been employed, this 
being brought to the standard of pure milk by the addition of water. 
Xjb is claimed that if the disease is not very far advanced, the sugar 
will disappear from the urine even in two weeks, and often at the 
end of five or six weeks, and in cases of long standing, that the 
progress of the affection will be arrested, even though a cure may 
not result. 

V. Ailments Seated in the External Coverings op 
the Body. 

Diseases of the Shin. 

There are a great many names to skin diseases, but, so far as 
treatment goes, they may be divided into but a few forms, which 
are not very hard to recognize. , The first is : — 

1. Those which have a moist, weeping or watery surface. This 
is caused by small blisters which break and discharge their contents. 
Under this head come grocers' itch, bakers' itch, bricklayers' itch, 
washerwomens' itch, moist tetter, salt rheum, bath itch, gum boils, 
fever blisters, milk crust, scald head, water pox, shingles, brow 
shingles, toothing rash, ringworm, canker sores. 

Eczema, apthas, and herpes are the medical names for these 
various complaints. 

How Treated. This is by diet, by local measures, by internal 
medicines. Spices, coffees, liquors of all sorts, pickles, and rich 
food, should not be taken. Meat should be taken in small quanti- 
ties. The bowels should be kept open by appropriate laxatives 
(see page 348). For the local treatment, the crusts should first be 
removed by soaking with oil and then washing with soap and warm 
water, or poulticing, if this does not answer. When they are all 



Ringworm. 1 91 

off, cover the part with a cloth wet with tar- water, made by stewing 
a teacupful of tar in a quart of boiling water. Or anoint the part 
with an ointment made of equal parts of tar and unsalted lard, or 
with oxide of zinc ointment (p. 356), an excellent application. 

The internal treatment is, in weak children and feeble elderly 
persons, a spoonful of cod-liver oil three times a day, and ten drops 
of the tincture of iron in water, after each meal. When the patient 
is otherwise robust, a somewhat low diet and an occasional cathartic 
will be required. 

Ringworm is quite common in children. Several different dis- 
eases are called by this name, but the one we have reference to 
appears as a small circle of watery pimples, which extends, and leaves 
in its centre a dry, branny surface. When it first appears it may be 
checked by bathing the part frequently with vinegar in which a 
piece of blue vitriol has been dissolved, or painting it with tincture 
of cantharides. Later, the oxide of zinc ointment is to be applied. 
Scratching should be avoided. Attention to the general health is 
called for when ringworms appear often. 

2. Those with a dry, pimply or lumpy surface, without discharge. 

This class is next common to the first one. It embraces those 
ailments whose common names are, nettle rash, prickly heat, hives, 
dry hives, pimples, wabash scratches, camp itch, soldier's itch, 
ground itch, night itch, winter itch, grubs in the face, or black 
heads, rose, rose rash, wind pox, barbers' itch, beard itch, tetter. 

The medical names it includes are, urticaria, roseola, acne, lichen, 
prurigo, molluscum, sycosis. 

Most of these complaints are characterized by more or less itch- 
ing and prickling, and this is the symptom which the patient par- 
ticularly wishes abated. For nettle rash, or hives, bathing the part 
in hot mustard water is often sufficient. The " cooling sal-ammo- 
niac wash" (p. 355) is a valuable application. Bathing with dilute 
vinegar also gives relief. For camp or ground itch, the parts 
should be rubbed thoroughly with common soft soap, every night, 
for three nights, which should be well washed off the next morning, 
and the oxide of zinc ointment (p. 356) or the lead ointment (p. 
354) gently rubbed in. The internal treatment and diet should be 
the same as given for the previous class of ailments. Grubs on 



192 Diseases of Adults. 

the face may be removed by washing repeatedly with ether, or with 
water somewhat strong with washing soda, or with a tablespoonful 
of alum in a basinful. 

Barbers' Itch is the development of pimples and pustules in 
the beard and whiskers. Each pimple, if examined, will be found 
to have a hair passing through it. There is but one way to set 
about curing this troublesome and disfiguring disease, and that is as 
follows: Remove the crusts by oil and poultices. Cut the beard 
short with scissors. Then pull out every hair that is seen to come 
from a yellow point or pimple. A small forceps should be used for 
this. When this is completed, rub thoroughly with the following 
ointment : — 

Take of Flowers of Sulphur, one scruple. 

White Precipitate of Mercury, one scruple. 

Carbolic Acid, pure, ten drops. 

Fresh Lard, ' one ounce. 

Mix well. 
Repeat this treatment, plucking out the hairs, as directed, and con- 
tinue as long as there are any yellow points. Do not shave for 
at least six months alter the disease has left. 

3. Those which have a dry. scaly surface. 

Of these, the public has familiar names for dandruff, dry tetter, 
scaly tetter, chapped hands, cracked lips, leprosy. 

The treatment in most of the cases of these diseases is by cleans- 
ing the surface well with a wash of common soft soap and warm 
water, and then anointing the part with some mild, slightly stimu- 
lating ointment, one of the best of which is the camphor ointment, 
given p. 356. 

4. Those caused by insects in or under the skin. 

First, we shall speak of the true itch, scabies or psora. This is 
a very contagious disease, caused by the burrowing of the itch mite 
under the skin. The irritation it causes gives rise to a little pustule, 
whieh is soon broken by scratching, and the fluid escapes and dries 
into a crust. 

The most successful mode of dealing with an ordinary case of 
scabies is as follows : — The patient before going to bed should soak 
for an hour in a warm bath, and scour himself well with soap and 
flannel; when thoroughly dry, he should rub in plenty of simple 



Flea Bites. 193 

sulphur ointment (p. 356), all over his body, arms, legs, hands, 
and feet, but especially between the fingers and toes, and on the 
flexed side of the limbs. He should then put on a long pair of 
drawers, gloves, and socks to prevent the ointment from rubbing 
off, or a long night dress, gloves, and socks will answer the purpose 
tolerably well. He should then go to bed for ten or twelve hours. 
If it is important that the smell of sulphur should be removed during 
the day ; he may take a warm bath in the morning, and then follow 
his usual occupation. At night, the process should be repeated. 
A third application is sometimes, but not generally necessary, pro- 
vided the ointment has been thoroughly applied in the first instance, 
and in sufficient quantity. A single application is usually sufficient 
if the ointment, after being well rubbed into every part of the body, 
is allowed to remain undisturbed for twenty-four hours. 

Lice. These disgusting insects are easily transferred from one 
person to another, and give rise to much irritation and even eruption 
of the skin. Sometimes they breed with inconceivable rapidity, 
especially on dirty or broken-down subjects. 

The treatment is simple. The clothes should be baked, for 
washing alone will not kill the insects ; a warm bath should be taken, 
and the skin anointed with stavesaere ointment (one drachm to one 
ounce). Flannel should be discontinued next the skin until the 
eruption is well. A strong tea of tobacco and mercurial ointment 
also destroy them. 

The louse which frequents the hair differs from that found in the 
clothing. It can be destroyed by the same measures. 

The crab-louse occurs in the hair on the trunk, under the arm- 
pits, etc. He is exceedingly tenacious of life. Mercurial ointment, 
or calomel rubbed in, is generally sufficient, however. 

Flea Bites sometimes give children and those of tender skins th< 
appearance of having a skin disease. These pests can be driven 
away by sprinkling the under-clothes with carbolic acid, or oil of 
peppermint. 

5. Those in which the skin is permanently discolored. 
Such are moles, mother's marks, liver spots, Saint Anthony's fire, 
rose rash, tan, freckles, white spots, red nose, sunburn, face blotches, 
bronzed skin, India ink marks, nitrate of silver stains, tattooing, etc. 

17 



194 Diseases of Adults. 

They arise from the various causes their names denote, and some 
are hereditary. Though classed as diseases, they are more properly 
disfigurements. Some of them, as mother's marks, moles, and 
India ink marks, require careful surgery to displace. Those which 
may be treated by simpler means will be found considered, with the 
receipts appropriate for their removal, on pages 365, 366. 

Diseases of the Hair. 

The most usual diseases of the hair are falling, eczema, dandruff, 
also seborrhoea. 

Falling of the Hair, or alopecia, without obvious reason, generally 
depends upon want of vigor in the scalp, and can be remedied by 
stimulating applications. We give, later in this work, the recipes 
for a number of well-tried hair tonics, which are appropriate in 
these cases (pp. 363, 364). 

Eczema of the Scalp. This is shown by a moist, watery dis- 
charge on the scalp. It dries up, forms scabs, and mats the hairs 
together. One form of scald head, in children, is of this nature. 
Its treatment should be that given under the first class of skin dis- 
eases, to which it belongs. 

Dandruff is the well-known diy, branny scurf, which many per- 
sons show on their coats and in their hair. Its cure can usually be 
accomplished by washing with soap and warm water, and then, when 
dry, rubbing in the ointment No. 188, p. 356. 

Seborrhoea has thicker, more solid, and coarser scales than dand- 
ruff. It is a frequent cause of early baldness in adult life. Often, 
the scalp itches considerably and is sore to the touch. The treat- 
ment is to rub well with oil, and wash with soap, to remove the 
crusts, which will have to be done more than once, as a rule ; then, 
to rub the scalp three times a week with a wash of soft water, con- 
taining a teaspoonful of carbolic acid to the pint; and finally, anoint 
the roots of the hairs carefully with a mixture of equal parts of zinc 
ointment and white precipitate ointment, which can be had from 
any druggist. 

Scald Head. This, called by physicians tinea, is a contagious 
disease, found chiefly on the heads of children, and is caused by 
the growth of a vegetable fungus. In its early stages, it is charac- 



Blisters. 195 

terized by the formation of little sulphur-colored and cupped crusts; 
these coalesce, and form yellow masses of a honey-comb appearance, 
and having a peculiar smell, as of mice. The disease is of a very 
chronic character. 

The treatment consists in destroying the vegetable parasite. For 
this purpose, a strong sulphurous acid lotion, of one part of the 
acid to one or two of water, should be continuously applied, under 
oiled silk, to the diseased surface, and kept constantly moist; the 
crusts, when softened by this application, should be from time to 
time removed ; this constitutes tbe first part of the treatment. The 
second consists in pulling out the hairs of the affected part, and 
using the ointment given for barbers' itch. 

Diseases of the Nails. 

Hang-nails. The loose fragments of nails which bear this 
name should always be carefully removed, as they may, by their 
irritation, produce felons, and other inflammatory troubles. 

Ingrown Nails. These usually are found on the toes, especially 
the big toe. They are very painful and obstinate. To heal them, 
the middle of the nail should be scraped with a piece of glass until 
it is quite thin. Then the edge which has grown under the flesh 
should be gently but firmly pressed upward by inserting under it a 
roll of lint or soft cotton. The raw edge of the flesh should be 
fastened down, away from the nail, with narrow strips of adhesive 
plaster, and a loose shoe be worn. Perseverance in this plan will 
effect a cure. 

Miscellaneous External Affections. 

We now throw together, under an alphabetical arrangement, the 
treatment of several external ailments, in addition to those men- 
tioned above, which will be looked for under this heading. 

Blisters, or blebs on the skin, are sometimes raised by han- 
dling irritating substances, animal or vegetable, as Spanish flies, 
potato bugs, parsnip leaves, poison oak, and from burns, quick lime, 
the sun's rays, and so on. The rule is not to open them, but to 
pass a needle through them, carrying a white woolen or loose cotton 



196 Diseases of Adults. 

thread. Theii cut off the thread each side of the blister, leaving 
the part between the cuts in the bleb. The fluid will drain out, 
and the surface skin promptly unite with that below it. 

In blisters of the feet, from walking, and of the hands, from 
rowing, the same method is employed. 

Blood Blisters rise on the skin when one of the small skin 
blood-vessels is broken. If not the result of an accident, they are 
often the sign of bad health, and point to the necessity of a good 
diet, tonics, cod-liver oil, and change of air. 

Boils or Furuncles. These are great pests to some people, and 
many ways are suggested to "backen" them. The best is to apply 
heat as soon as there is any sign of one. Hot water, long con- 
tinued, will often succeed. When matter has once formed, warm 
poultices should be applied, and the boil opened with a sharp knife, 
so that the core can loosen. 

When a person has crop after crop of boils, ir is a sign of en- 
feebled health. Peruvian bark or quinine should be taken with 
iron (see pp. 3G0, 361). 

For a blind boil, which is a dull, obstinate sore, opening with a 
knife, and poulticing, is the proper treatment. 

Bunions are hard, tender swellings, which appear on the ball, 
the outer portion of the second joint of the big toe, or on the 
insteps. Tight or short shoes produce them. A loose, but well- 
fitting and flexible shoe must be worn, and the swelling painted, 
several times a week, with tincture of iodine or a weak solution of 
carbolic acid. 

Carbuncle. This is a large and malignant boil, very painful, 
and even dangerous, as it indicates a low state of health. It is flat 
and firm, with a crust with several imperfect openings, from which 
the matter passes out. This, and its size, and the intense pain 
accompanying, distinguishes it from a common boil. At times it 
is infectious, induced by the reception of an animal poison (from 
cattle) into the system. This is called "malignant pustule." 

Horn Treated. The only efficient plan of treating a carbuncle 
is to divide it crosswise, with a sharp surgical knife, early in its 
course, and then poultice it steadily. The system should be kept 
up with tonics, and stong, nourishing food, with ale or porter. 



Goitre. 197 

Corns. The cure of these common annoyances is easy, but 
troublesome. The foot should be thoroughly soaked in warm water, 
and all of the corn removed with a dull penknife, but no pain 
should be produced. When this is felt, it is a sign that the knife 
is going too far. Then the little cavity should be surrounded with 
flat rings of wash leather, or felt, or corn plaster, leaving a hollow 
centre. A drop or two of sweet oil should be placed in this, and 
the foot clothed in a soft stocking, and a loose, easy shoe. This 
process, repeated twice or three times a week, for a month or two, 
will cure a corn ; but it will return if tight, ill-fitting shoes are 
resumed. 

Felon, or Whitlow. This is a very painful inflammation of 
the finger, arising from a bruise, from the entrance of a needle or 
splinter, a hang-nail, or other irritant. When milder, it is called a 
"flesh felon;" when severe, affecting the bone, a "bone felon." 
The former begins generally at one side of the root of the nail, or 
in the bulb of the finger end, with redness, swelling, and a throb- 
bing, burning pain, shooting up the hand and arm. 

These symptoms are very much increased in severity in the 
second variety. The patient holds his hand up, as the pain is more 
acute when it is dropped. The appetite suffers, and sleep is dis- 
turbed or prevented. 

At the outset, a felon may be backened, at times, by holding the 
hand for a half-bour in water as hot as may be borne, and then 
wrapping it in a large hot poultice. After this is done, leeches may 
be applied, so as to draw blood freely from the part. These meas- 
ures failing, the next measure, which should not be delayed, is to 
open freely the swelling, with a sharp knife, cutting, in a bone felon, 
fully to the bone. This, alone, will prevent the danger of having 
a stiff, mutilated, and useless finger for a lifetime. After the in- 
cision, poultices and warm water dressing will complete the cure. 

Goitre, Derbyshire neck, or swelled throat, is a deformity common 
in mountainous countries. Its cause is not ascertained. The 
swelling is in front and at the base of the neck. It is painless, but 
is unsightly, and may become troublesome by pressure on the wind- 
pipe and large blood-vessels. When of many years' standing, it 
cannot be cured ; but when comparatively recent, rubbing with the 

17* 



Diseases of Adults. 



following ointment, three times a week for several months, will 
cause it to disappear. 

Take of Iodide of Cadmium, one drachm. 

Fresh Lard, one ounce. 

Mix. Rub in a portion the size of a small pea. 

Goitre is liable to return, however, unless a change of residence 
is adopted. 

Sores and Ulcers. Cold sore, leg sore, or indolent ulcer. 
These are names given to those obstinate sores, or issues, that come 
on the legs of persons, especially those in advanced life, whose 
systems are below par, and who have suffered from swollen veins, 
rheumatism, frosted feet, and similar troubles. They are not very 
Fig 58. painful, but are foul, debilitating, and 

difficult to heal. 

The treatment is local and internal. 
Good hygiene, great cleanliness, para 
air, nourishing, simple diet, and iron 
or cod-liver oil, daily, are essential. 
Then locally apply the carbonate of 
ammonia ointment, given on page 356^ 
taking care to wash the sore by a 
stream of warm suds from castile 
soap. This done, cut long strips of 
sticking plaster about a half inch wide, 
and long enough to go once and a 
half round the limb. Applying the 
middle of one of these to the opposite 
side of the limb from the ulcer, the 
two ends are brought forward across 
this with a firm pressure, so as to bring 
together, as much as may be, the edges 
of the sore. A number of straps, so 
applied (leaving places for the matter 
to escape), completes the dressing. 
This should be repeated once or twice 
a week. This method of bandaging a leg is shown in Fisrure 58. 
Sweating, excessive. Persons of a stout habit occasionally suf- 




Bandaging a Leg with Adhe 

sive Strips 



Warts. 199 

fer from excessive perspiration, which, though it may not be injuri- 
ous, is disagreeable. It may be diminished by avoiding warm 
baths, changing the underclothing frequently, and sponging the 
body with a lotion consisting of two teaspoonfuls of dilute sulphuric 
acid, in a quart of water. The skin, when dried, should be pow- 
dered with starch or pulverized asbestos. 

Fetid, or Foul Feet, from excessive sweating, are a great annoy- 
ance to some. Benefit in such cases will be derived from bathing 
the feet, night and morning, with a mixture of half an ounce of 
tannic acid in a pint of cologne water, drying, and powdering with 
starch or dry tannic acid. 

Warts. These ugly excrescences are best dispersed by rubbing 
them, night and morning, with a piece of muriate of ammonia (sal- 
ammoniac), moistened with water- 




CHAPTER VI. 



ACCIDENTS, INJURIES, AND POISONS. 

General Directions for Treating Accidents, Bandages, Splints, 
and DBE8SINGS.— Bed Sores. Jj:tcs: of Mad Dogs— Hydrophobia, Ra- 
bies— of Snakes, Spiders. Bleeding or Hemorrhage : from Wounds— from 
Nose— from Large Arteries. Blows: Wounds from. Bones: Broken- 
Out of Joint— (fractures and dislocations). Brain: Compression and Con- 
cussion of. Bruises: Blows— Contusions. Burns and Scalds : Scars from. 
Cuts. Browned : To Restore. Fainting and Faint Spells. Falls: Hurts 
from. Frozen Persons: to Restore— Frozen Limbs— Chilblains— Frost 
Bite. Railroad Injuries : Spinal Shock. Rings : to get off. Rapt teres, or 
Hernia: Trusses. Sears: from Wounds — Burns — Small-Pox. Shock: 
Sprains and Strains— Stings of Insects. Stroke: Sun-stroke — Heat-stroke 
Sun — Headache — Sun Pain — Lightning Stroke. Suffocation ami Strangu- 
lation: Choking, or Asphyxia, Suspended Animation — from Hanging — 
from Fixed Air— Well Damp, or Carbonic Acid Gas— from Charcoal 
Fumes— from Common Burning Gas— from Coal Gas and Choke Damp. 
Teeth Knocked out. Things : in the Eye — in the Ear — in the Nose — in the 
Throat— in the Lower Bowel — in the Flesh — Needles — Pins — Fish-IIooks. 
Veins: Swollen — Bursting of. Wounds: How to Dress — Bandages — 
Gunshot W'ounds — Torn Wounds— Cuts — Stabs and Thrusts — Cut 
Throat — Scalp Wounds. Passive Movements : For Wounds and Injuries 
— Illustrations of. 

Poisons and Poisonings— General Directions: Alcohol— Aconite— Am- 
monia — Antimony — Arsenic — Baryta — Belladonna — Bismuth — Bitter 
Sweet — Camphor — Copper — Corrosive Sublimate — Digitalis — Iodine — 
Iron — Lead — Mushrooms — Nitrate of Silver — Opium— Oxalic Acid— Poi- 
son Ivy, or Vine — Prussic Acid — Phosphorus — Savine — Stramonium — 
Strychnia — Tobacco. Laying out the Dead. 



General Directions for Treating Accidents. 



When a person witnesses an accident, his duty is to render imme- 
diate assistance. And if he is not wanted for this purpose, to go about 
200 



Bandages and Dressings. 201 

his business forthwith, and not to form one of a gaping, staring crowd. 
What a person who is hurt needs first, is plenty of air. He 
should not be surrounded by many persons, and if in a room, the 
windows should be opened. There should be no hurry nor rude- 
ness in moving him. Often ill-directed attempts to do so mate- 
rially aggravate his sufferings, and the danger from the injury. 

If a person has been thrown from a carriage, injured by a fall 
from a height, blow, or other cause ; while there may be no frac- 
ture, or other external injury evident, the nervous system has 
received what is called a "shock." As is commonly said, the per- 
son is " faint." 

A person situated with such symptoms, should, if possible, be 
placed flat on the back, with the head, neck, and shoulders slightly 
raised. The limbs, at the same time, should be straightened out, 
if practicable, so that the heart, already feeble in action, may act at 
as little disadvantage as possible. The cravat, collar, and every- 
thing else calculated to in any way impede the circulation toward 
the head, or the movements of the chest, should be loosened or 
removed. If the injury is slight, reaction will soon come on after 
giving the person a sip of cold water; spirits and water (teaspoon- 
ful in tablespoonful of cold water every couple of minutes), or 
aromatic spirits of ammonia (twenty drops in a tablespoonful of 
cold water) every couple of minutes. Gentle frictions to the ex- 
tremities, a few drops of cologne water on a handkerchief, to the 
nostrils ; if the weather is hot, the use of a palm-leaf fan ; hot 
flannels to the limbs and pit of the stomach, are all likewise useful 
in assisting reaction. 

Bandages and Dressings. 

Every one should be prepared to give at least the first attention 
to severe accidents. To do this properly, they should know some- 
thing about roller bandages, splints, and simple dressings for 



A roller is made of stout white cotton cloth, about three fingers 
wide, and of any desired length. 

It is generally rolled from one end only, and is then called a 



202 



Accidents, Injuries and Poisons. 



Fig. 59. 



A Roller Bandage. 



single-leaded roller (a). But if it be rolled from both ends, so 
that the rolls meet in the middle, it is a double-headed roller (b) ; 
this is not, however, often used, as it is 
not very convenient. 

For those who have the opportunity 
of having assistance, a roller can be bet- 
ter applied by an attendant than by them- 
selves. But such as prefer being inde- 
pendent may soon learn to put on their 
roller very well. The foot as well as the 
leg should be rolled, and the rolling should be begun at the toes 
and finished just below, or what is much better, immediately above 
the knee. 

How to Bandage a Leg. Presuming the person is right-handed, 
he will take a single-headed roller in his right hand, holding its 
circumference between his thumb and fingers, and laying its loose 
end on top of the foot at the root of the toes, he fixes it there with 
the thumb of the left hand whilst the roller itself is carried beneath 
the sole and round the foot, and twice or thrice round in the same 
place till it get a good hold on the foot. The roller is then to be 
turned round and round the foot towards the heel, each turn half 

covering the former 
one, and as the roller 
passes beneath the 
foot, it is delivered 
from the right to 
the left hand, and 
then as it passes over 
the foot, from the 
left to the right 
hand. Having ar- 
rived at the instep, 



Fig. 60. 




Bandaging a Leg. 



the roller is now carried round the ankle, made to descend to the 
opposite side of the foot from which it had been brought, passed 
beneath the sole, and then carried round the ankle again, thus form- 
ing a fisure of eight, one loop containing the foot, the other the 
ankle-joint, and the gripe of the loops on the instep; this figure-of- 



Bandages and Dressings. 



203 



Fig. 61. 




eight turn generally requires twice making to give the roller a good 
start up the leg. The roller is now turned round the leg, each turn 
half covering the former, and delivered from hand to hand alter- 
nately, from within to without or from without to within, according 
to which leg is being rolled. When all is wound, the end is to 
be securely pinned. 

On rounded parts of the body, as the head, buttocks, etc., it is 
not easy to apply any sort of roller band- 
ages. When it is desired to protect such 
portions, a square bandage may be cut 
into the form of a Maltese cross. Its 
four arms will then fold down smoothly 
one over the other, and the whole may be 
fastened by adhesive strips. The pattern 
of such a bandage will readily be under- 
stood from Figure 61. 

Sometimes, when a leg or thigh is broken and much injured, it 
is desirable to renew its bandage without lifting the limb. This is 
accomplished by a simple and ingenious device known as the many- 
tailed, or Scultetus bandage. A 
width of the ordinary roller, are 
laid adjacent, as shown in Figure 
62, and upon these the limb is 
laid. The ends of each strip 
are then brought to the front of 
the limb, folded, and fastened. 
Any single strip can then be 
replaced, without lifting the limb, 
by pinning one of the same 
length to its end and drawing it 
under the limb. A Many-tailed Bandage. 

Of all applications to a broken or much injured limb, water, hot 
or cold, simple or medicated, stands first in importance. Everybody 
should know how to keep a limb constantly moist, and constantly at 
the same temperature. This is called irrigating a limb. The 
very simple apparatus shown in Figure 63, which can be easily 
constructed, answers the purpose admirably. A small bucket 



A 4-tailed Bandage. 



number of single strips, of the 
Fig 62. 




204 



Accidents, Injuries and Poisons. 



is suspended from the ceiling. A pipe, with a number of small 
apertures, is fastened to its bottom. The flow, is regulated by the 
stop-cock. The bed is protected by a rubber cloth. And thus the 
limb is constantly bathed in a gentle stream of fluid of any required 
temperature. No treatment is more efficacious to reduce swelling 
prevent inflammation, and hasten recovery. The general rule is 
that^ the temperature of the fluid be that most agreeable to the 
patient. 

Fig. 63. 




Irrigating a Limb. 
We shall now mention, in alphabetical sequence, the most common 
accidents and injuries, with their appropriate treatment. 

Bed Sores. These sores are apt to come on projecting points 



Bites. 205 

of the body of a patient who is long confined to bed. The following 
directions will generally prevent their recurrence : — 

1. The under sheet should be kept smooth and free from wrinkles 
or crumbs. 

2. The patient should be kept as dry as possible, all discharges 
being cleared away frequently. 

3. The position of the patient should be varied as frequently as 



4. The back should be examined daily and washed with a strong 
solution of spirits of wine, and, after having been thoroughly dried, 
should be dusted with flour starch or powdered oxide of zinc. 

5. When any indication of redness appears, the patient should 
be supplied with a water or air cushion, or the part should be 
covered with some thick felt or amadou plaster, having a circular 
hole corresponding to the inflamed spot. 

When they have come, they must be treated as 1 we shall describe 
under wounds. 

Bites. The bite of a dog is a common accident, and always 
deserves the most prompt and energetic attention, as there is always 
a possibility of madness, hydrophobia or rabies. Even angry dogs 
are said to communicate the disease sometimes by their bites, and 
the same is asserted of the common skunk or pole-cat. The same 
precautions should be used in every case as if we knew the dog was 
mad. If these precautions are thoroughly and immediately applied, 
there is not the least danger, even from the bite of a really mad dog. 
There are four things to do, and we give them in the order in which 
they should be done : — 

1. Ligation. — Tie a string tightly between the part bitten and 
the body. This can always be done when it is a leg or an arm 
which is bitten, as is usually the case. It is to prevent the poison 
from being absorbed into the system. 

2. Washing. — Wash the wound thoroughly, pouring abundance 
of water on it from a height, or hold it under a full stream from a 
pump or hydrant. 

3. Suction. — Rinse the mouth and suck the wound as hard as 
possible, and for fifteen or twenty minutes, spitting out the blood, 
etc., which flows. 

18 



206 



Accidents, Injuries and Poisons. 



4. Burning. — The wound should finally be cauterized or 
burned. Carbolic acid, and nitrate of silver, or lunar caustic, are 
tbe best for this purpose. But nitric or sulphuric acid will answer, 
or a red-hot poker, or live coals. It is no time to be timid about 
the means. 

When these are done, put a light poultice on the wound, keep 
quiet until the slough comes off, and dismiss the matter from the 
mind, for all danger is past. 

For bites of rattlesnakes, vipers, moccasins, tarantulas, spiders, 
and other poisonous serpents and reptiles, the same four precautions 
are to be taken. Often the poison so exhausts and depresses the 
system that stimulants are required. Spirits may be given, or, 
what is better, spirits of ammonia, twenty or thirty drops in water 
every quarter of an hour, as required. 

Bleeding, or Hemorrhage. This always acccompanies wounds, 
and is generally most alarming to bystanders. There is no occasion 
for fright, as people do not bleed to death very quickly. Retain 
your presence of mind, and remember that three things are to be 
done, all of which you can do at once. Take time to notice the 
color of the blood. Blood from the arteries is a bright red color, and 
bursts out in spurts, while venous blood is a purple red, and flows 
in a steady stream. 

The three steps you can 
take to stop the blood are : — 
1. Pressure. — Should an 
artery or branch have been 
divided (indicated by a spurt- 
ing of a spray of bright blood 
at each beat of the heart), the 
firm pressure of the finger 
for some time, to the point of 
division, should be used, to 
diminish the size of the ves- 
sel at that point, until a clot 
is formed there. 

Sometimes, pressure to the 



Fig. u. 




Pressure to Check Bleeding from the 
Forearm. 



supposed seat of the injured 



Bleeding, or Hemorrhage. 



207 




vessel does not reach the artery. In such a case the pressure must 
be used to some known trunk between the original supply of the 
blood and the injured branch. Thus, if the finger or the toe is the 
seat of the arterial hemor- 
rhage, firm pressure applied 
each side of the finger, close 
to the hand (as in the cut), 
or toe, close to the foot, com- 
presses the arteries passing 
along to be distributed to 
the extremity. If the hand 
or foot is the seat of the in- 
jury, pressure on the wrist, 
OKer the point where the ar- 
tery is felt for the "pulse," 
or at the inside of the ankle, 
will materially retard the 
passage of the blood beyond Pressure to Check Bleeding from Finger. 
those points. 

2. Position. — The part from which the blood comes should be 
raised above the rest of the body, and if the patient become faint 
he should not be roused immediately, since faintness acts as nature's 
remedy by lessening the force and activity of the flow of blood. 

3. The Application of Cold. — This plan answers best when the 
bleeding is from several points scattered over a large surface ; it is 
conveniently applied by letting cold water drip from a sponge upon 
the bleeding points, or by the application of ice in a rubber bag, or 
bladder. 

When these immediate measures have been used, there is time 
enough to use what physicians call hemostatics, to stop the blood. 
Gallic acid is a cheap and convenient one. Still more handy is 
alum. Either may be dusted on the part in powder, or poured 
over in solution. Or the wound may be touched with nitrate of 
silver, or tincture of iron. But these measures are needless in 
ordinary cases. Sometimes, when a tooth is drawn, and the blood 
will not cease running, a piece of cotton, dampened with alum 



208 



Accidents, Injuries and Poisons. 



water, or sprinkled with alum powder, and applied, will check it 
promptly. 

Bleeding from the Nose. Bleeding from the nose is seldom 
serious, and may generally be controlled by the application of a lit- 
tle cold water. The patient should be kept upright, with his head 
thrown back and his hands raised above his head. Ice to the back 
of the neck is useful. If very obstinate, throw up ice-water, or a 
solution of gallic acid, with a syringe. 

Bleeding from Small Arteries. This can generally be stopped 
by firm and constant pressure on the point whence the blood spurts, 
as above described. If a forceps is at hand, torsion may be used. 
The end of the bleeding artery should be caught and twisted five 
or six turns, without pulling. Even quite large vessels will cease 
flowing if this is carefully done. 

Bleeding from Large Arteries. When one of the large arteries, 
which carry the bright red blood from the heart, is cut, there is 
required more active treatment. This is, to compress the main 
trunk of the artery, higher up, by the fingers, a strap and pad, or 
a tourniquet. We shall show how this is to be done in the various 
limbs. 

If the bleeding be from a wound 
in the arm, near the armpit, in 
which case nothing more can for 
the moment be done, a bystander 
should press his thumb firmly into 
the neck, behind the middle of the 
collar bone, which will stop the flow 
of blood through the great artery of 
the arm as it is first coming out of 
the chest. As, however, the pres- 
sure thus made soon tires the thumb, 
the handle of a door-key, wrapped 
in three or four folds of linen, may 
be pressed behind the middle of the 
collar bone, and held without fatigue for almost any length of time, 
till proper assistance can be obtained. 

When the wound is below the armpit, about the elbow, the pres- 



Fig. 66. 




Pressure to Check Bleeding at 
the Armpit. 



: ng, or Hemorrhage. 



209 
sure should be directed as shown in Fig. 67. The cut also shows 

Fig. 67. 




Pressure to Check Bleeding in Upper Arm. 
where pressure by the thumb can be used to check bleeding near the 
armpit. 

The arm and forearm, with dotted lines, indicate the course of 

Fig. 68. 




Handkerchief Tourniquet on the Arm- 



18" 



210 Accidents, Injuries and Poisons. 

the arteries, and points at which pressure can be most judiciously 
applied. 

The arrow points the course of the current of the blood of the 
artery, from the heart to the extremities. 

Permanent pressure is exerted by means of a temporary tourni- 
quet to the artery of the arm. A common folded handkerchief, 
with a firm, sharply-defined knot tied at the middle, a long strip of 
muslin torn from a shirt sleeve, or a suspender, with a suitable knot 
in it, is rather loosely tied around the arm, and the slack taken up 
by twisting with a cane or stick until the knot, kept over the ves- 
sel, exerts enough pressure to prevent the passage along it of the 
blood. 

The method of exerting pressure by the fingers along the course 
of the artery of the thigh, between the wound and the heart, is 
shown in Fig. 69. 

Fig. 69. 




Pressure on the Artery of the Thigh. 
Sometimes it is easier to find the artery nearer the surface, at a 
point along the dotted line, or a little higher up towards the groin. 
The two thumbs, placed together, furnish firm resistance; and a 
blunt stick, suitably protected, will often answer to keep up the 
pressure until a tourniquet can be extemporized. 



Bones, Broken or Fractured. 



Fig. 70 represents the tourniquet made as directed for the arm, 
by getting a large, firm knot in a handkerchief, or anything else of 
the kind. A small pebble has often been introduced for the . pur- 
pose, into the knot, with success. Twist the ligature with the 
leverage obtained by passing under it a cane or stick. 

Fig. 70. 




Handkerchief Tourniquet on tlie Thigh. 

Get the knot over the artery, keep the knot there, and tighten 
until the pressure of the knot closes the vessel. 

Bones, Broken op Fractured. Splints is the name surgeons 
give to the apparatus used to place along the broken fragments, to 
keep them in position. They are made of wood, rubber, leather, 
binders' board, tin, and many other materials. For general use 
those manufactured of stiff felt are the best. They come in sets, 
and are readily moulded, when hot, to any limb, and are firm 
and soft when cool. 

In instances of suspected fracture or dislocation of the thigh or 
leg, the injured parts should be placed in a comfortable position, 
and as well supported as possible, to prevent the twitchings of the 
leg from the spasmodic action of the muscles of the injured extremity. 
If necessary to remove the patient to his home or the hospital, 
from the spot where the accident happened, the arrangement of the 



212 



Accidettts, Injuries a?id Poisons. 



limb should be made after he has been placed on the stretcher or 
substitute. 

Fig. 71. 




Temporary Bandage for Fractured Limb. 

If found necessary to carry the injured person some distance, and 
a litter for the purpose cannot be had, the arrangement of the frac- 
tured limb against the other, and kept there by handkerchiefs, as 
shown in the cut (Fig. 71), is often of great comfort to the sufferer. 

By a little ingenuity a comfortable litter can be made by fasten- 
ing four stout poles together, and tying a blanket securely to them, 

Fig. 72. 




A Convenient Litter. 

so as to resemble the frame and sacking of a bedstead, and upon 
this the sufferer may be laid. Hand-carriage is infinitely more 
easy than carriage or cart, for every jolt over any irregularity in 
the road produces motion in the broken bone, and correspondingly 
severe pain. 

This should be carried by hand, two persons at each end taking 
hold of it, and all keeping step as they move along. 

We shall now describe particular fractures, which may be either 
simple, compound, or comminuted. 



Bones, Broken or Fractured. 



213 



Simple. When a bone is broken in one place without any ex- 
ternal wound. 

Compound. When a bone is broken in one place, and there is 
an external wound leading down to the broken bone. 

Comminuted. When a bone is broken in two or more places, as 
when a splinter of bone is broken off. 

Skull. Put the patient in bed, and let his head be shaved for 
some distance round the seat of injury, and wet lint with gutta- 
percha tissue applied over it. 

Lower Jaw. In this fracture the parts of the bone should be 
replaced in their natural position, the mouth closed, and the face 
bandaged so as to retain the fragments in place. The patient should 
be fed by a tube, which can be inserted where he has lost a tooth. 
Broth and milk must be his diet until the bones knit. A dentist 
can easily make a splint of rubber to fit inside the mouth, and thus 
hold the parts in position at less discomfort. 

Collar-Bone. Keep the patient in bed, without a pillow, with 
the arm on the injured side folded across the chest. The further 
treatment consists in placing high up in the hollow of the armpit 
a pad, about as big as two fists, and 
twice as wide, which must be kept in 
place by a tape at each end, passed 
one on the back, and the other on 
the front of the chest, and tied on a 
pad (to prevent galling) on the oppo- 
site side of the neck. A bandage 
is next to be turned once or twice 
round the arm, immediately above 
the elbow, and its two ends carried 
round the chest, one before the other 
behind, and tied so as to keep the 
elbow close to the side. The elbow 
and forearm are then put into a short Bandage and sllng for Colla ;_ 
sling, which lifts up the shoulder, and Bone Fracture, 

should be tied on the neck on the sound side. This done, all de- 
formity disappears, and the bone is set. The bandages thus put 
on must be worn about a month. 




214 Accidents, Injuries and Poisojis. 

Ribs. The patient should remain in bed, and a special rib 
bandage or flannel roller, six yards long and six or eight inches 
wide, be put round his chest ; a spittoon should be placed within 
his reach, and the character of the expectoration noticed. 

Broken Arm Above the Elbow. The pads and splints must be 
fitted on the sound arm before they are placed on the injured limb, 
and four of each will be required. The splints should be about three 
fingers' breadth wide ; one should reach from the shoulder to the 
bend of the elbow ; one behind, from the shoulder to the point of 
the elbow; one from the armpit to the jutting inside of the elbow; 
and one from the shoulder to the jutting outside of the elbow. 
The pads should be a little wider than the splints, and about two 
inches longer, so that they may be turned over each end of the 
splint, and tacked to prevent them slipping out. Two long rollers 
are also needful. The immediate swelling after the accident having 
subsided, the limb must be placed with the forearm bent at a right 
angle with the upper. The hand and arm are to be lightly swathed 
FJ(r 74 in the roller, the turns of which 

should overlap each other, and 
be continued a little above the 
elbow. The object of this is to 
prevent the swelling which 
generally follows the appliance 
of the splints. The second roller 
is now to be wound round the 
arm twice or three times, above 
the elbow; then the first splint 
is to be placed on the front of 
the upper arm, but not quite 
Bandage and Splints for Fracture of down to the bend of the elbow, 
pper r ' and two or three turns of the 

roller made round it ; next the back splint from the shoulder to 
the elbow placed against the arm, and the roller earned round it 
twice or thrice; the third splint is now put on at the inside, its 
upper end being pushed up into the armpit, not so high, how- 
ever, as to rub against and gall it; and the fourth on the outside; 
around these the roller is now to be wound, anil continued till 




Bones, Broken or Fractured. 215 

the whole arm, with the splints, has been swathed from the arm- 
pit to the bend of the elbow. A short sling is then put round 
the neck, which must only support the hand and wrist. By thus 
doing, the weight of the elbow drags down the lower end of the 
bone, and keeps the broken portions in place. The splints rarely 
require being touched for ten days or a fortnight, and must then 
be again applied in the same manner. They must be worn a 
month or five weeks. There is no need of keeping the person in 
bed, and indeed it is advisable he should be up, as the broken bone 
keeps its position better than when in bed. 

Broken arm Below the Elbow. There are two bones in the fore- 
arm, and when both are broken there is little difficulty in discov- 
ering the nature of the accident. But if only one be broken, it is 
not so easy for an unpracticed person to distinguish it ; but this is 
of less consequence, as the sound bone serves for a splint to keep 
the broken one pretty nearly in its place, even though no splints be 
put on. 

If both bones be broken, two padded splints are required, 
extending from the tips of the fingers to the bend of the elbow in 
front, and to the point of the 
elbow behind. The forearm is 
now to be bent on the elbow; 
the splints applied, one before 
and the other behind, and both 
bound firmly to the arm with a 
roller from the fingers up to the 
bend of the elbow. The arm 
then, resting on its back, is to be 
put in a sling, which shall sup- 
port it from the elbow to the 
7, i mi t Bandage and Splints for Fracture of 

finger ends, lne splints must Lower Arm. 

be kept on about a month. 

Broken Fingers. If the first or second joint of either of the 
fingers be broken, it is readily discovered; but not so easily if it be 
the third joint, which, however, is but rarely broken without more 
serious mischief. 

A piece of thin wood or stiff pasteboard, as wide and as long as 




216 Accidents, Injuries and Poisons. 

the finger, is to be placed on its front, or same side as the palm of 
the hand. Upon this, the finger being laid straight, it is to be 
bound with a roller an inch wide from end to end. It is best to 
keep the hand in a sling for three weeks or a month, and not to 
attempt using it till after that time. The broken finger often 
remains stiff a long while after it has become well knit together; 
it is therefore a good plan to render the joints supple by thrusting 
the hand for half an hour daily into warm grains ; but if these 
cannot be procured, soaking it for the same time in warm water, 
and afterward to bend the finger gently forward and backward, as 
far as it can be moved without pain. 

Broken Thigh If this accident occur in any part a little distant 
from the hip or knee-joint, it is easily ascertained by the unnatural 
bending at the scat of injury, and by the person being unable to lift 
up the leg below the broken part, as well as by his not liking to 
attempt it on account of the pain produced by the ends of the bone 
pushing into the flesh. This is a much more serious accident than 
either of those already mentioned, and is managed with difficulty 
by any but an expert surgeon. When none is near, the limb should 
be gently, but firmly, drawn down, so that the bones are restored to 
their natural position. The simplest plan is then to lay narrow bags, 
eighteen inches long and six inches in diameter, loosely filled with 
sand, along the outer course of the limb. Keep it constantly irri- 
gated, and if it tends to become displaced by contraction of the 
muscles, a brick should be suspended to a rope passing over a pulley 
at the foot of the bed, and fastened by a string around the ankle. 
In nearly every case, no matter how well treated, there remains 
slight shortening of the limb and a limp in the walk. 

p lg - 6< In fracture of the leg, below 

be knee, we also have either 
one or two bones, as in the arm 
below the elbow. Here, too, 
one may serve as a splint to the 
other. When the accident oc- 
curs, the patient should be put 



Box for Broken Leg. in bed, the limb gently brought 



Bones Out of Joint, or Dislocated. 



217 



to its natural shape by the hands of the attendant, and then placed 
in a box, as shown in Fig. 76. 

Between the sides of the box and the limb, sand bags can be laid, 
or, if there is an outer wound, bran or sawdust. A sling can be 
placed around the ankle, and passing through two holes in the foot- 
board, may be used to keep the leg in a firm and natural position. 
This fracture usually lays the patient up for six weeks. 

Bones Out of Joint, or Dislocated. On pages 51 and 52 
of this book, the reader has seen the different ways in which nature 
has connected the bones of the body. When this connection is 
violently separated, the bone is said to be "out of joint," or "dislo- 
cated." The signs of this accident are, first, a deformity, seen and 
felt, caused by the presence of the end of the bone in its new place ; 
second, inability to use the limb which is dislocated ; third, pain and 
swelling about the joint injured. Often, the limb has quite an 
unusual turn or twist, which at once reveals the trouble. 

The general rules for treating a person with dislocation are, to 
convey them promptly to their homes, give some aromatic spirits 
of ammonia, or spirits, if there is much shock, place them in the 
most comfortable position, and then proceed, with due deliberation, 
to the setting or reduction of the bone. There is no hurry about 
this, and a day or two's delay, if the Fig. 77. 

joint is protected and irrigated by 
cold water, is often more of a benefit 
than otherwise. Hence, if by such 
delay experienced help can be sum- 
moned, it should be sent for. When 
this help cannot be obtained, careful 
observance of the following methods, 
applicable to the more common dis- 
locations, will be in order. 

Dislocation of the Jaw. The re- 
duction or replacing of a dislocated 
jaw, either on one or both sides, is very 
easily managed. The patient being Reducing a Jaw out of Joint. 
seated on the floor, and his head resting against the operator's 
knees, who stands behind him, a couple of fork handles, or two 
19 




218 



Accidents, Injuries and Poisons. 



pieces of hard wood, about the same size, are to be passed into the 
mouth, one at each comer, and to be pressed back as far as they 
will go, between the back teeth on each side, and there held by 
another person. The operator then, bending over the patient, and 
• passing his own fingers between one another so as to make a loop 
of both hands, places them under the chin, and pulls it up so as 
to close the mouth. As this is doing, the joint-ends of the jaw- 
bone are made to descend, and as soon as they reach the edge of 
their sockets, are pulled into place, and the dislocation is reduced. 
Care must be taken that the pulling up of the chin be made level, 
and that the forkhandles both retain their place. 

Dislocation of the Cottar-Bone. This is a troublesome and 
rather common accident. The head of the bone forms a protrusion 
over the upper part of the breast-bone. To restore it, the shoulder 
should be pressed upward, outward, and backward, and the end of 

the bone pressed up- 
ward, with the ringer 
and thumb, into its 
place. To retain it 
there, a bandage should 
be applied across both 
shoulders, and around 
the chest, the applica- 
tion of which will be 
more apparent from the 
opposite figure than from 
a verbal description. 

.This should be worn 
night and day, for five 
or six weeks. This 
accident is very apt to 
leave a deformity after 
it, in spite of every 
care. 
Bandage for a Collar-Bone out of Joint. Dislocation of the 

Arm at the Armpit. This is also a very common accident, and with 
some persons it occurs over and over again, with slight provocation: 




Bones Out of Joint, or Dislocated. 



219 



The patient and the person who is to pull the arm into place 



both lie down on a sofa, or still better, 
upon the floor, on their backs, side by 
side, but in contrary directions, so that 
the feet of the one are at the shoulder of 
the other, on the side where the displace- 
ment is. The operator then, having taken 
off his shoe, and put a folded towel in 
the patient's armpit, puts his foot upon 
it, between the chest and the arm, using 
the right foot if the right shoulder be 
dislocated, and the left if the left shoulder. 
He then grasps the patient's wrist with 
both hands, and pulls the arm* down 
steadily. At the same time he tells the 
patient to make some little change in his 
position, and thus inducing him to call 
some other muscles into action, the 
resistance to the reduction, which the 
muscles of the dislocated shoulder had 
been previously offering, is for a moment 
suspended, and at that moment the opera- 
tor pulls a little more vigorously, and 
generally the bone immediately returns to 



Fig. 79. 



its socket with a more or less 
A person who has repeat- 
edly dislocated his shoulder, 
may, if he have courage to 
bear a little pain for a few 
minutes, even manage, him- 
self, to reduce it, if the acci- 
dent have happened whilst he 
is out in the fields, and there 
be a five-barred gate at hand. 
All he has to do is to get his 
arm over the top rail, and 
then, having grasped the low- 



loud 



snap. 




Reducing an Arm out of 
Joint. 



Pig. 80. 




Reducing an Arm out of Joint with- 
out Assistance, 



220 Accidents, Injuries and Poisons. 

est rail he can reach, hold fast, and let the whole weight of his 
body hano- n the other side of the gate; and then, if he make 
some little attempt to change the position of his body, still, however, 
letting its weight tell on the top of the gate, the bone will probably 
slip into its place. The principle on which this is done is exactly 
the same as when the heel is put in the armpit and the arm pulled, 
Fig . si. that is, to move the head or top of the 

arrn-bone to the edge of its socket, 
below which, when dislocated, it had 
dropped, and this done, the muscles of 
their own accord pull it into place. 

Dislocation of the Thigh at the Hip- 
pud does not so frequently recur after 
one displacement as the dislocation of 
the sboulder. just mentioned. Persons 
who have baa dislocation of the hip 
two or three times are pretty much as 
well aware of it as those whose shoul- 
der has been put out. 

If there be tolerable reason for be- 
\ lieving that the thigh is really dislocated, 
its reduction may be attempted in the 
same way as dislocation of the shoulder. 
At any rate, an attempt is worth trial. 
The patient and the operator both lie 
down on their backs, and assistants bold 
the hips of the former steady, so that 
they shall not sway about. The opera- 
tor then puts his leg between the pa- 
tient's legs and presses his foot close 
up to the fork, which must be pro- 
tected with a towel; he then grasps the 
patient's ankle with both hands, and 
•pulls, bids the patient change his posi- 
ttle, "and, whilst he is thus engaged, pulls a little more 
briskly, and probably succeeds in replacing the bone, which goes 
in with a snap. 




Reducing a Thigh out of Joi 



Bones Out of Joint, or Dislocated. 



221 



Dislocation of the Fingers and Toes. These smaller boaes are 
readily recognized when they are put out of place. But it is not 
so easy to restore them as might be imagined. The figure given 
below shows very clearly how the index finger appears when dislo- 
cated at its third joint. Firm, strong pulling in the line indicated 

Fig. 82. 




The Index Finger out of Joint. 

will sometimes reduce it. But generally, to obtain a better "pur- 
chase," one has to use what sailors Fig. 83. 
call the "clove hitch." A tape is 
folded as shown in Figure 83. 
This is slipped over the finger, 
the two ends are grasped with 
one hand by the assistant, while 
with the other he steadies the 
wrist of the patient and makes 
traction in the natural line of the 
finger. This method is further 

shown in Tne clOYe Hitch. 

Figure 84. 





Reducing a Finger out of Joint. 
In Dislocation of the Toes the bone can be restored to its place by 
the same means. 
19* 



222 Accidents, Injuries and Poisons. 

Reduction of fractures, that is, "bone-setting," as it is popularly 
called, is always easier when the patient is under the influence of 
ether or chloroform. After it has been accomplished, rest and 
cold irrigation for a few days should be observed, and subsequently 
"passive motion" of the limb, which will be explained further on. 
Brain, Concussion and Compression of. These are two varieties 
of injury to the brain, the latter more severe, and marked by the 
patient being perfectly insensible, and labored, snoring breathing. 
The former is a stun, the patient can be partially aroused, and his 
skin is cool. 

In both cases, the injured person should be put to bed, cold 
applied to the head by ice bags, or cold compresses, the room kept 
quiet and dark, visitors excluded, and if he is much prostrated, hot 
bricks to his feet. So long as the pulse is steady, and the breath- 
ing natural there is no danger. Do not give stimulants, or excite 
him in any way. 

In cases of compression of brain, there is 
much more danger to life than when it is merely 
concussed. Treatment, therefore, should be 
more active, and in its line, nothing yields bet- 
ter results than to take some blood at the back 
of the neck by cups, either wet, that is, those 
that are used to draw the blood externally, or 
Cuppin^back of ^ ^ ^ where m cufcting imminent is 

employed ( see page 344). The location of the cups is shown in 
the above figure. 

Bruises, Blows, or Contusions, are flesh injuries where neither 
skin nor bone is broken. Cold and rest are the application^ for 
them at first. For the former, see p. 342. To forestall a " black 
eye," as soon as the blow is received, keep the part constantly wet 
with the spirit wash, p. 355, or the arnica lotion, p. 350. For 
jammed toes, or fingers caught in a window or door, the most 
speedy mode of procuring relief, immediately after the occurrence, 
is to plunge the finger into as hot water as can be borne. By so 
doing the nail is softened, and yields, or accommodates itself to the 
blood poured out beneath it, so that the agony is soon diminished. 




Bums and Scalds. 223 

The finger may then be advantageously wrapped up in a bread-and- 
water poultice. 

After the first pain and swelling of the bruise disappear, the 
discoloration, which remains may be dispersed by gentle and long 
rubbing with camphor liniment (p. 353). 

When a person is shaken and bruised all over, by a fall from a 
horse, or the like, a warm bath gives great relief, if he is not faint. 

Burns and Scalds. These common accidents, by receiving 
early and suitable attention, are often deprived of much of their 
inconvenience. Of course, the first thing is to put the fire out, 
and then, if the injured parts require it, the clothing should be cut 
away, so as to get at the entire extent of the injury with as little 
trouble to the patient as possible. Should any fragment of gar- 
ment appear adherent to the burned surface, the sticking part 
should be left, as the violence required to remove it must necessarily 
increase the damage to the injured part. 

Fig. 86. 



f» 



m 






Extinguishing Flames on Clothing. 

When the clothing catches fire, throw the person down on the 
ground, as the flames will tend less to rise toward the mouth and 
nostrils. Then, without a moment's delay, roll the person in the 
carpet or hearth-rug, so as to stifle the flames, leaving only the head 
out for breathing. If no carpet or rug can be had, then take off 
your coat and use it instead. Keep the flame as much as possible 
from the face, so as to prevent the entrance of the hot air into the 
lungs. This can be done by beginning at the neck and shoulders 
with the wrapping. 

If the burn or scald involves considerable surface, symptoms of 



224 Accidents, Injuries and Poisons. 

shock are observed, from the extreme of mere weakness to that of 
utter prostration. This at once requires prompt attention, and a 
few drops of aromatic spirits of ammonia in water, or a little 
brandy, should be given every few moments until a return of 
the strength is seen. A burn ; superficial, as far as depth is con- 
cerned, but covering a large surface, especially in the case of small 
children and aged people, is usually considered more dangerous, as 
far as life is concerned, than a burn smaller in extent, but deeper 
and more complete. 

If the burn or scald is slight in character, one of the best appli- 
cations is cold water dressing, keeping the linens used constantly 
wet with cold water. In a short time after the pain shall have 
moderated, one of the best things for use, and readily procured, is 
a dressing of pure hog's larcL 

If the burn or scald, particularly the latter, is supeificial in char- 
acter, a simple and useful dressing is the application, by a brush or 
a soft wisp of old muslin, of the white of egg to the injury. As 
soon as the first layer dries, another should be used. 

A lather of soap, from the shaving cup, applied by the brush in 
the same way, is often followed by immediate relief. These sub- 
stances appear to protect from the action of the air the irritated 
nerves beneath. Do not apply cotton to the injury, as sooner or 
later it increases the pain, and without having done any special 
good. 

Where the effects of the burn or scald extend deeper, involving 
the subcutaneous tissue, or even the parts beneath that, as the mus- 
cle, other considerations must not be overlooked. There probably 
will be more shock. The portion whose vitality has been destroyed 
by the burn cannot do otherwise than become detached from the 
uninjured parts beneath, and thrown off in the shape of shreds or 
larger masses, during the process of sloughing. After water dress- 
ing has given a degree of relief to the part, poulticing must be 
commenced. After being used for a short time, a mark of well- 
defined separation is seen at the junction of the burned and the 
unburned parts. 

If the arm, at the elbow, is burned or scalded, so that a scar 
results, the contraction of this tissue will often draw up the forearm 



Drowning. 225 

to a right angle, from which it cannot be straightened. A burn or 
scald at the front of the neck is often followed by a dense white 
scar, which, contracting, draws the chin down toward the chest, 
and the lower lip down toward the chin, ending in the greatest 
deformity. 

Burns and scalds practically differ but little from each other. 
Scalds are usually more confined to the outer cuticle, unless the 
substance containing the heat is viscid in character, as oil, pitch, 
etc., and does not rapidly run off the part with which it came in 
contact. As far as treatment is concerned, the two may be regarded 
as presenting no essential difference. 

Burns by lime, caustic potash and other alkalies. Lime rapidly 
destroys the parts with which it comes in contact. It is useless 
to attempt to pick it off, for the fingers remove no more than they 
get hold of, so an application should at once be made of something 
to unite with the alkali, to form a comparatively harmless prepara- 
tion; vinegar diluted with water, the acid in lemon-juice, or any 
other dilute acid, will answer. What has been said about the 
alkali known as lime may be said about the other alkalies, potash, 
soda, ammonia, etc. 

Burns by acids — sulphuric acid {oil of vitriol), nitric acid 
{aquafortis), etc. In these cases, applications of water will dilute 
them beyond their capacity to injure. Alkalies applied neutralize 
acids into harmless preparations. Common earth, gathered almost 
anywhere, applied in handfuls, contains alkali enough of one kind 
or another to entitle it to the consideration of being one of the best 
(and at the same time most easily secured) applications in cases of 
burns by acids. 

Cuts. These will be spoken of under wounds. 

Drowning. This frequent accident every one should learn how 
to treat. 

The body should be recovered as soon as possible from the water; 
the face turned downward for a moment, with the forefinger of a 
bystander slightly curved and thrust backward to depress the 
tongue, to favor the escape of a small quantity of water, or mucus, 
or other substances, often collected at the base of the tongue, over 
the entrance to the windpipe, which tend to obstruct the entrance 



226 



Accidents, Injuries and Poisons. 



of air to the lungs. The practice of rolling a person over a barrel, 
or hanging him head downward, to permit the escape of water 
from the lungs, is of no use. The body should be conveyed to the 
nearest house, a messenger having been previously dispatched to 
make the arrangements involved in the following: — As soon as the 
body arrives it should be stripped of the clothing, rapidly dried, 
placed on a bed previously warmed, the head, neck, and shoulders, 
raised a very little, if any ; frictions with the dry hands used to the 
extremities, and heated flannels kept applied to the rest of the body. 

If artificial breathing can now be carried out fur some time, it 
may be that the natural respiration can take place. Two methods 
are usually employed for the purpose, the first known as "Silvester's 
Ready Method." 

This consists, after the above suggestions have been carried out, in 
pulling the tongue forward, which better favors the passage of air 
along the base of the tongue into the trachea (windpipe), and then 
drawing the arms away from the sides of the body and upward, so 
as to meet over the head, by means of which the ribs are raised 
Fig. 87. 




Artificial Respiration, 
(expansion of the chest) by the muscles (pectoral) running from 
them to the arms near the shoulder. A vacuum is thus created in 
the lungs, the air rushes in, and the blood then is purified by the 
passage of the impure gases in the blood vessels to the air, and by 



Drowning. 227 

the giving up by the air of a portion of its oxygen to the blood. 
The arms are now brought down to the sides, and the elbows made 
to almost meet over what is called the "pit of the stomach." This 
produces contraction of the walls of the chest, and expulsion of the 
impure air from the lungs. 

These two movements constitute an act of respiration, and should 
be persisted in, without interruption, at the rate of about sixteen to 
the minute. In other words, each complete movement should 
occupy about four seconds, which is about the natural rate of respi- 
ration in health. 

The second " Ready Method," as it is called, is that of Marshall 
Hall. 

The person whose breathing is to be restored is placed flat on 
the face, gentle pressure is then made on the back, the pressure 
removed, thfe body turned on its side, or a little beyond that. The 
body is then turned again on the face, gentle pressure again used 
to the back, then turned on the side. This should be done about 
sixteen times in a minute. 

Both of these methods have the same object in view; either may 
be exclusively used, or one may be alternated with the other. 
Most physicians express a preference for the first described ("Ready 
Method of Silvester)". Both of these procedures might be prac- 
ticed in advance by the reader, because such practice might be 
more easily remembered than a concise rule. 

In speaking of the restoration of persons drowned, it is often 
said that he was a good swimmer, and must have been attacked 
with "cramp." This is a spasmodic contraction of the muscles 
beyond the control of the individual, and occurs after exhaustion 
of the muscles from over-exertion. Persons suffering from debility, 
especially the debility peculiarly affecting the nervous system, 
should never be induced to go beyond depth in the water, or out of 
reach of immediate assistance. There is no warning in advance of 
the seizure, and the person sinks at once. Many lives are lost each 
season, in shallow as well as in deep water, from these seizures, 
which could have been avoided" had the bather, perhaps just recov- 
ering from an attack of sickness, or even of indisposition, not 
neglected the precautions stated. 



228 



Accidents, Injuries and Poisons. 



Recovery from drowning can scarcely be expected to take place 
after an immersion of five or six minutes, although there are well 
authenticated cases where restoration has taken place after an 
immersion of as much as twenty minutes. The efforts ought to be 
made, and persisted in, for at least a couple of hours. As soon 
as returning vitality permits, a few drops of brandy, in a little 
water, may be given ; and as the strength of the person is usually 
completely exhausted, from muscular efforts of the most violent and 
continued character, to save himself from drowning, some beef tea, 
or other easily digested nourishment, should be given. 

The accident of drowning is so frequent that we go still further 
into the treatment of it. and copy into our pages the detailed rules 
published by the Life Saving Society, of New York. At the risk 
of repetition, we show then method. Three steps are to be taken : 

Fig. 88. 




The First Movement. 

1. Remove all obstructions to breathing. Instantly loosen or 
cut apart all neck and waist bands ; turn the patient on his face, 
with the head down hill; stand astride the hips with your face 
toward his head, and locking your fingers together under his belly, 
raise the body as high as you can without lifting the forehead off 
the ground (Fig. 88), and give the body a smart jerk to remove 
mucus from the throat, and water from the windpipe; hold the 
body suspended long enough to slowly count one. two, three, four, 
five, repeating the jerk more gently two or three times. 



Drowning. 



229 



2. Place the patient on the ground, face downward, and main- 
taining all the while your position astride the body, grasp the points 
of the shoulders by the clothing, or, if the body is naked, thrust 
Fig. 




The Second Movement. 

your fingers into the armpits, clasping your thumbs over the points 

of the shoulders, and raise the chest as high as you can (Fig. 89), 

without lifting the head quite off the ground, and hold it long 

Fig. 90. 




The Third Movement, 
enough to slowly count one, two, three. Replace him on the 
ground, with his forehead on his flexed arm, the neck straightened 
20 



230 Accidents, Injuries and Poisons. 

out, and the mouth and nose free. Place your elbows against -your 
knees, and your hands upon the sides of his chest (Fig. 90), over 
the lower ribs, and press downward and inward with increasing 
force, long enough to slowly count one, two. Then suddenly let 
go, grasp the shoulders as before, and raise the chest (Fig. 89) ; 
then press upon the ribs, etc. (Fig. 90). These alternate move- 
ments should be repeated ten to fifteen times a minute for an hour 
at least, unless breathing is restored sooner. Use the same regular- 
ity as in natural breathing. 

3. After breathing has commenced, restore the animal heat. 
Wrap him in warm blankets, apply bottles of hot water, hot bricks, 
or anything to restore heat. Warm the head nearly as fast as the 
body,' lest convulsions come on. Rubbing the body with warm cloths 
or the hand, and slapping the fleshy parts, may assist to restore warmth, 
and the breathing also. If the patient can surely swallow, give hot 
coffee, tea, milk, or a little hot sling. Give spirits sparingly, lest 
they produce depression. Place the patient in a warm bed, and 
give him plenty of fresh air ; keep him quiet. 

Faintness. In any case of faintness, the patient should be at 
once placed in a recumbent position, the head lower than the rest 
of the body, all tight clothing about the neck and chest loosened, 
and a supply of fresh, cold air secured. 

Water dashed on the face, or applied by means of a wet towel, 
is the best restorative. 

If smelling salts or any preparation of ammonia be used, care 
must be taken that they are not used too persistently, as serious 
injur}' may be thereby caused to the lining membrane of the breath- 
ing pass 

Vails, Hurts from. These are generally bruises or broken 
bones, to which headings the reader is referred. 

Frozen Limbs, Frost-bite, or Chilblains, When the circu- 
lation of any part begins to succumb to the influence of the cold, it 
becomes puffy, bluish, and smarting. This is because the blood 
moves more slowly than natural through the vessels exposed near 
the surface. Soon this blueness disappears, and the part becomes 
pallid, as if the influence of the cold had contracted the vessels to 
an extent incompatible with the passage of blood through them. 



Frozen Limbs. 231 

The pain at this point ceases ; indeed, until he meets a friend, he 
often does not know of his mishap. At this stage the injury has 
become so great that, unless proper means are taken to restore cir- 
culation, complete death of the part ensues, and in due time sloughs 
away, and is detached from the line of Hying tissue. 

What takes place in a part of the body, known as frost-bite, may 
take place in the whole of it, which is known as "frozen to death." 
There is increasing difficulty in breathing, owing to the engorged 
state of the chest, and, what should always be remembered by one so 
exposed to cold, an unconquerable desire to sleep. To sleep then 
is to die. If the person exhibits such a symptom, he must, by all 
means, be kept constantly moving. 

Persons exposed like those just described must be treated 
promptly, and with one thing never lost sight of. That is, keep 
the frozen person away from the heat. A person taken up insensi- 
ble, or approaching it, from exposure to the cold, should be taken 
into a cold room, his clothing removed, and thoroughly rubbed with 
snow, or cloths wrung out with ice water. The friction to every 
part of the body, particularly the extremities, must be continued 
for some time, until signs of returning animation appear. When 
the frozen limbs show signs of life, the person should be carefully 
dried; put into a cold bed in a cold room; artificial respiration 
used until the natural is established; then brandy given, also gin- 
ger tea, and beef tea. Do not forget that the patient is to be 
brought by degrees into rather warmer air ; and lest in some part 
there might still be defective circulation, the person should be kept 
away from exposure to the heat of the fire. 

Milder degrees of the same condition, as suspension of life in 
the ear, nose, finger, or toe, from exposure to cold, must be treated 
with the same general directions in view. The part should be kept 
away from the heat, and rubbed with handfuls of snow, or towels 
dipped in cold water, until circulation appears re-established. Ex- 
posure of the part to the heat before, we may say, it has been 
almost rebuilt, is apt to be followed by sloughing. 

For Chilblains. Keeping the feet warm by wearing worsted 
stockings, and encouraging the circulation by rubbing once or twice 
a day with soap liniment, or mustard liniment, is the best mode of 



232 Accidents, Injuries and Poisons. 

managing chilblains in their first stage. The itching may be also 
for a time relieved by brushing over the inflamed skin with dilute 
sulphuric acid. But when the chilblains have broken, a bread-and- 
milk or linseed-meal poultice is the best application. 

Railroad Injuries. The violent shock which the body receives 
in the collision and crash of a railroad smash-up produces some- 
times a peculiar internal injury, a spinal shock. The person so 
hurt does not feel it much at the time. He may run around and 
aid other passengers, but in a few hours or days his limbs fail and 
he becomes partly paralyzed. 

As soon as any such symptoms appear he should take to bed and 
seek medical advice, as it may prove to be a lasting injury. 

Rings, to get off. Sometimes rings remaining a long time on 
the finger cause, by the growth of the latter, constriction, pain, and 
swelling. To remove them, wrap the finger, commencing at its tip, 
with fine thread, very tightly. On reaching the ring slip the end 
of the thread under it, oil or soap the finger well, and thus work 
the ring down. A gold ring, when this fails, can be readily broken 
by first rubbing it with quicksilver. 

Ruptures or Hernia. This is a common weakness. It is caused 
by a portion of the bowels or their covering slipping out of their 
natural position in the cavity of the abdomen. If happening after 
birth, a rupture shows itself as a swelling suddenly appearing in 
the groin after violent exertion; remaining distinct while the person 
stands upright, disappearing when he lies down, and returning 
again when he gets up. It also usually fills out when he coughs. 
If let alone it continues increasing in size, so that instead of the 
bowels being contained, as they should be, in the belly, the greater 
part drop into the swelling, which may become of an enormous size. 

The proper treatment for a rupture is the wearing of a well-fitting 
truss. It should never be laid aside for a day. The bowels should 
never be allowed to become costive. 

When through neglect of precaution the bowel "comes down" 
and will not return, the rupture is said to be "strangulated." This 
is a dangerous condition, and one should be able to recognize it. 
When a person has been costive two or three days, and he becomes 
violently and frequently sick, at first throwing up stuff like coffee- 



Shock. 233 

grounds, and after some hours like stools, and very offensive ; if 
there be a feeling of a cord tied round the midriff, constant feeling 
of sickness, much uneasiness and anxiety, there is great reason for 
supposing that this has something to do with a rupture. The 
inquiry should be made, and if there is a rupture, and it has fallen 
down, immediate treatment is required. 

The patient may be put into a warm bath up to his neck, and 
kept there till he feel very faint; he may then attempt, according 
to his own usual method, to put the rupture up, by pressing it 
gently, if it be in the groin, or by lifting it up if in the purse, and 
gently squeezing it toward the belly, but no violence must be used, 
or the gut will burst. 

If this do not succeed, cold may be applied over the swelling, 
by filling a bladder with pounded ice and a small handful of salt, 
or with a freezing mixture consisting of Grlauber salt and sal- 
ammoniac, to which some water must be added. Either of these, 
after being kept on some hours, will occasionally cause the return 
of a rupture, but they require to be used with some caution, as 
if the skin become frosted it may mortify. If neither ice nor the 
materials for the freezing mixture can be obtained, a wet rag may 
be put on the part, and evaporation encouraged by a continued 
stream of air from a pair of bellows, repeatedly wetting the cloth 
as it dries ; by these means almost as great a degree of cold can be 
produced as by ice. 

Some surgeons have of late strongly recommended attempting 
reduction of a rupture by reversing the position of the body; in 
other words, by holding the patient head downward, or nearly so, 
and they state that in many instances this method has succeeded. 

Scars, from wounds, burns, small-pox, etc. Many of these are 
disfiguring, some painful. Repeated rubbing with some stimulat- 
ing ointment, as that of carbonate of ammonia (p. 356), has been 
recommended. Frequently, however, nothing but a surgical opera- 
tion will remove them. In "webbed fingers," and wry neck, from 
burn scars, this is always advisable. 

Shock is the violent disturbance of the system after accidents, 
which does not show itself in any special part. It is, however, 
often dangerous. Loss of blood, bathing in cold water when heated, 
20* 



234 Accidents, Injuries and Poisons. 

or drinking it in excess, certain poisons, as tobacco and antimony, 
burns, and falls, produce it. Tbe patient lies in a state of utter 
prostration. There is pallor of the whole surface, the lips are 
bloodless and pale. The eyes have lost their lustre, and the eyeball 
is usually partially covered by the drooping upper lid. The nos- 
trils are usually dilated. The skin is covered with a cold, clammy 
moisture, often gathered in beads of sweat upon the forehead. The 
temperature is cold, and perhaps the person shivers. 

The treatment consists in first placing the patient as flat on his 
back as possible, with the head raised not over an inch. This is an 
important point in cases of ordinary fainting, and whenever the 
vital powers are depressed stimulants are required. A teaspoon- 
ful of spirits, in a tablespuonful of water, every minute, until six 
or eight have been taken, is tbe best way to give it. • If the tem- 
perature of the body is raised by it, and there seems a revival of 
the action of the heart, enough brandy has been given. Twenty 
drops of the aromatic spirits of ammonia, in a teaspoonful of water, 
may be given every couple of minutes, until four or five doses have 
been taken. The applications of heat to the extremities and "pit 
of the stomach," are very useful. Flannels wrung out in hot 
water, or bottles of hot water properly wrapped up, should not be 
neglected. Mustard plasters to the pit of the stomach are often 
us id. Nausea ami vomiting often are seen in shock, and can best 
be allayed by getting the patient to swallow, whole, small chips of 
ice. lee can be easily chipped by standing the piece with the grain 
upright, and splitting off a thin edge with the point of a pin. 

Sprains and Strains. These occur when the sinews or mus- 
cles are violently wrenched. The ankle and wrist are especially apt 
to suffer thus. 

When a joint has been sprained, it should be kept perfectly at 
rest, and if the ankle or knee, the person should lie in bed, or on a 
Bofa. Warm, moist flannels should be repeatedly applied for some 
hours, and a bread-and-water poultice on going to bed. These 
should be continued for a few days, and no attempt made at using 
the joint. If the pain be very severe, and continue so for the first 
or following days, leeches may be applied, and repeated once or 
oftener. Some persons are fond of putting a vinegar-poultice on at 



Stroke. 235 

once; but this is better after the tenderness has subsided, and there 
remain only a little pain and stiffness in the joint; then a vinegar- 
poultice is a very good application. 

When the pain has entirely ceased, the joint must not be care- 
lessly used ; and, if it be the knee or ankle sprained, walking till 
the joint becomes weak and aches must be most carefully avoided, 
as irreparable mischief is thereby very often set up. Short and 
gentle walks only, therefore, should be taken, and may be repeated 
by degrees more frequently during the day, if they do not produce 
pain or fatigue. 

A joint often swells a long while after a sprain, under which 
circumstance it is best to bind it up with straps of soap-plaster or a 
roller. 

Stings of hornets, wasps, and bees, are wounds, not made by the 
insect to obtain food, but in anger and for 
its own defence; and into these wounds, 
which are made by a sharp dart at the 
extremity of the body, and which is hollow, 
poison secreted in twisted tubes (a a), which 
pour it into a little bag (b) specially formed 
as a reservoir, is thrown by the sting dart (d), 
which protrudes from between a sheath 
formed bv two side plates (c c) at the end 

J r v y The sting and p olgon 

of the insect s body. Bag of a Bee. 

A stimulating application to the injury, as a drop of aromatic 
spirits of ammonia, will often afford the greatest relief. A pinch 
of common table salt, dampened with water and rubbed in, is very 
useful for the same purpose ; likewise a slice of onion rubbed on 
gives almost instant comfort; or the application of wet clay, or 
cosmoline. 

Stroke. Sun-stroke. This is a common accident in the intense 
heats of American summer. It does not always need the sun to 
bring it on, as great heat in the shade may cause it. This is called 
"heatstroke." 

Before it comes, there is pain in the head, wandering of the 
thoughts, irritable temper, nervousness, and general ill-feeling. 




236 Accidents, Injuries and Poisons. 

"Sun-headache " and " sun-pain" show that there is unusual danger 
from this source. 

How Prevented. — During hot weather all alcoholic drinks must 
be avoided. A bath should be taken daily. Abundant cool, but 
not ice-cold, water should be taken. The head should be well 
protected by a tall straw hat, with a damp newspaper or sponge, 
a wet handkerchief or a handful of green leaves, in the crown. 
When the heat is felt unpleasantly, exposure to it should cease. 

Treatment. — Tbe person attacked should at once be carried to a 
cool, airy spot, iu tbe shadow of a wall, or to a large room in a 
house with a bare floor; or, what is often better, if there is no sun, 
he should be placed in a back yard, on the pavement. 

The clothing Bhould be at once gently removed, and the patient 
placed on bis back, with the head raised a couple of inches by a 
folded garment. Then the entire body, particularly the head and 
chest, dashed with cold water in profusion. While preparations are 
being made for this, a messenger should be despatched for a good 
supply of ice. A large fragment should be placed in a towel, and 
struck a lew times against the side of the house, to reduce it rapidly 
to small pieces. These pieces, mixed by the hand into a bucket of 
water, will promptly supply ice-water. Two buckets can be used, 
each half full of the small ice, and as soon as the water of one is 
used for dashing against the patient, another will be ready for the 
same purpose. The ice-water must not be sprinkled over the 
person, but dashed against him in large bowlfuls, particularly 
against the head and chest. While one person makes the ice- 
water, and another uses it. a third should, in the same manner, 
with a towel, break some ice in fragments not larger than almonds. 
A double handful, at feast, of these bits should be placed in a thin, 
coarse towel, the ends gathered up and fastened with a string, as 
you would a pudding. Then holding to the tied portion of the 
collection of ice, the entire surface of the body should be rapidly 
rubbed. 

These measures are to reduce the heat of the body. When the 
decline in the heat is noticed, the cold applications should be 
abandoned, the patient carefully removed to a dry spot, and the 
entire surface of the body dried off with toweb. Should a tendency 



Suspen ded A nimation. 237 

to a return of the high temperature be seen, as sometimes happens, 
even after consciousness is restored, it must be met by a renewal of 
the cold applications. 

Artificial respiration, until the natural returns, must be resorted 
to as soon as the heated condition of the body is overcome. The 
dashing of cold water over the chest and face is a useful means of 
encouraging a return of the life force. 

Stroke of Lightning. A person struck by lightning is usually 
rendered more or less unconscious by it, which lasts for a longer or 
shorter time. 

The burns caused by lightning should receive the same attention 
as burns from any other cause. 

When the person exhibits little or no signs of life, the clothing 
should be rapidly and immediately removed, the body exposed to a 
dashing of cold water; then dried, placed in a bed, and warmth 
applied, particularly to the "pit of the stomach," by means of 
bottles filled with hot water, or the tin vessel kept in some house- 
holds for such application. It is somewhat concave on one 
surface, filled with hot water, and, if it can be had, is well adapted 
to the purpose. 

Artificial respiration should be kept up until the parts of the 
brain and nervous system in charge of this duty shall have recovered 
enough to attend to it. Recoveries after an hour of supposed 
death are on record. 

Some stimulant, as the aromatic spirits of ammonia, may be 
employed. 

Suspended Animation. Thisisthe term applied by medical men 
to apparent, but not real death, from the breathing of gases, such as 
fixed air or carbonic acid gas, well-damp and choke-damp, charcoal 
fumes, common burning gas, and coal gas; from strangulation, 
hanging, or suffocation. Of course, death will result from any of 
these causes; but frequently the sufferer is only seemingly dead 
when discovered, and may be brought to life by appropriate means. 
These, in all the circumstances mentioned, are pretty nearly the 



Old wells and brewers' vats very often are filled with fixed air or 
carbonic acid gas, and are rendered very dangerous to enter by its 



238 Accidents, Injuries and Poisons. 

presence. A person breathing it will drop insensible and die in a 
few minutes unless rescued. 

Buckets of water dashed down into the well, or masses of lighted 
shavings or blazing paper, give enough movement to the carbonic 
acid gas to dislodge it from its resting-place. After testing the 
success of the effort, by again introducing the lighted candle, it can 
soon be known whether a person may enter with impunity. 
Freshly-slaked lime also rapidly absorbs it. 

When a person appears overcome with the carbonic acid gas, he 
is, of course, wbolly unable to help himself, and he must at once 
be removed by another. No time should be lost in descending or 
arising, as the person lowered depends upon doing everything dur- 
ing the interval he can hold his breath ; for, of course, should he 
inhale the gas, his position, in this respect, would be but little bet- 
ter than the man he attempts to succor. A large sack is sometimes 
thrown over the head and shoulders of the person who descends. 
It contains enough air to serve for several inhalations, while the 
texture of the material prevents, to a hurtful degree, the admission 
of the gas. 

The person suffering from asphyxia from the gas, immediately 
after being brought out, should be placed on his back, the neck and 
throat bared, and any other obstacles to the breathing quickly 
removed. His body should then be quickly stripped, and if he 
have not fallen into water on being overpowered by the gas, his 
head. neck, and shoulders, freely dashed with cold water. A per- 
son should stand off some distance, with a bowl of cold water, and 
throw its contents, with as much force as possible, against the parts. 
Others should follow, without interval, for half a minute, while one 
can count thirty slowly, then the dripping water be wiped away by 
a towel. This procedure should be repeated from time to time, as 
apparently required. Sometimes, if a brook of water is near, the 
stripped person might be dipped again and again ; being careful, of 
course, not to dip in his face. Artificial respiration should be 
used with as little intermission as possible. 

Should the person have fallen in the water, and become chilled, 
the use of the cold water, in this manner, had better be avoided, as 
the evaporation of moisture absorbs more heat than can be mann- 



Things in the Eye. 



239 



factured by the exhausted and overpowered system. In such a 
case, the body of the person should be put into a warmed bed, with 
hot applications, and artificial respiration at once established, as in 
drowning. 

While artificial respiration is being used, friction applied to the 
limbs should be kept up. 

Teeth Knocked Out. When this happens, the bleeding should 
be stopped by the use of cold water, and the tooth should be imme- 
diately replaced in its socket and fastened by a piece of silk thread. 
It will often regain its position and usefulness by this precaution. 

Things in the Eye. A great deal of pain is often suffered 
from various substances getting in the eye. The best way to 
remove them is by holding a knitting- Fig. 92. 

needle over the upper lid, close to 
and just under the edge of the orbit, 
then, holding it firmly, seize the 
lashes of that lid by the fingers of 
the disengaged hand, and gently turn 
the lid upward and backward over 
the needle, or substitute used. Move- 
ment of the eyeball by the sufferer, 
in a strong light, usually reveals the 
presence of the intruding body, so 
that by means of a corner of a silk 
or cambric handkerchief, it can be detached and removed. 

Should the foreign body be imbedded in the membrane covering 
the eyeball or the eyelid, a steady hand and a sharp-pointed instru- 
ment will usually lift it out. 

The foreign body often cannot be seen, but the person assures us 
he feels it. Often he does not really feel the presence of the body, 
as much as the roughness left by it. In such a case, or even if 
the body has been seen and removed, a soothing application to the 
injury is as useful as the same thing applied to a wound of the 
hand. Take a spoon or cup, heat it, and pour in a few drops of 
laudanum. It will soon become dense and jelly-like. A few drops 
of water added will dissolve this gummy material, and the liquid 
thus formed may be applied by the finger to the " inside of the eye," 




Removing an Object from the 
Eye. 




240 Accidents, Injuries and Poisons. 

as they say. The laudanum is opium dissolved in alcohol. The 
alcohol is somewhat irritating, but is easily evaporated by the gentle 
heat, leaving an extract of opium, which is dissolved in the water 
afterward added. 

Lime, soda, or potash, not unfrequently gains entrance into the 
Fig. 93. eyes of those working in these substances. 

A dry camel's hair brush will remove them, 
but if not at hand, time should not be 
wasted in trying to pick them out, but a little 
vinegar or lemon-juice, diluted with water, 
should be thrown into the eye, which will 
rapidly neutralize their injurious action. 

After an injury of this kind to the eye, 
or any other which causes pain and inflamma- 
tion, this precious organ should be bandaged, 
and excluded from the light. The plan of 
Band tftheEye' DJUry doing this is shown in Fig. 93. The strips 
a a a are applied first, b b over them, and pinned or sewed where 
they cross. 

Things in the Ear. Insects sometimes get into the ear, and 
cause much inconvenience, even if they do not sting and produce 
further mischief. The best mode of proceeding, in such case, is to 
fill the ear with sweet oil. which will kill the animal by stopping up 
its breathing pores, and generally floats it out. But if it be not 
thus dislodged, it must be washed out with a syringe and warm 
water. 

When peas, beans, pebbles, or such like are found in the ears of 
children, attempts should never be made to get them but with a 
knitting-needle, or a stick. The rounded end of a hair-pin may 
sometimes be used. But the safest is to employ a syringe with a 
narrow nozzle, which will throw a good stream of water behind the 
object, and thus force it out. 

The earwig is a small, winged insect, which has its name from 
the frequency with which it has been the cause of trouble by entering 
the ear. Pouring in oil will soon destroy it. In cases where this 
means is not at hand, as in hunting, blowing tobacco smoke in the 
ear will kill or stupefy it and similar intruders. 



Needles, Fish- Hooks, and Pins in the Flesh. 241 

Things in the Nose. Children sometimes amuse themselves 
with poking things with which they are at play into their noses. 
If peas, beans, or any other seed or substance be thrust in, which 
swell as they moisten, no time should be lost in getting them out, 
otherwise, as they enlarge, they become more firmly fixed, and more 
difficult to be removed, are attended with great pain and suffering, 
and may even cause dangerous consequences. Hard substances, as 
shells, which remain unchanged in bulk by moisture, are of less 
consequence, and may remain some days without causing much 
inconvenience, and often drop out of themselves. 

If the pea or shell be in the nostril, the child should be made to 
draw his breath in deeply, and then stopping the other nostril with 
the finger, and closing the mouth firmly, to snort forcibly through 
that side of the nose in which the substance is lodged. If this be 
done soon after the accident, two or three efforts usually shoot the 
unwelcome lodger out. But if this does not succeed, the nose must 
be lightly nipped with the finger and thumb above the pea or shell, 
so as to prevent it getting further in, and then the eyed end of a 
bodkin or probe, having been a little bent, must be gently insinu- 
ated between the bottom of the nose and the substance, and when 
introduced sufficiently far, must be gently used as a hook to bring 
it down. 

Things in the Throat, Gullet, and Windpipe. Choking 
and strangling from pieces of food or bones of fish are by no means 
rare. The body should be bent forward, when several smart blows, 
high up between the shoulders, will sometimes dislodge it. This 
failing, it had better be extracted with the curved end of a long 
hair-pin, or the loop at the end of a scissors blade, which can be 
unriveted for the purpose. If the object is an artificial tooth or 
other hard and pointed substance, care must be had not to injure 
the throat in efforts to get it out. 

Objects in the wind-pipe cause severe coughing and choking, the 
sufferer becoming, at times, quite black in the face. A surgical 
operation is required in desperate cases; while some have been 
relieved by being held head downwards. This must be tried with 
caution, however. 

Needles, Fish-hooks, and Pins in the Flesh. Needles often 
21 



242 Accidents, Injuries and Poisons. 

enter the flesh and remain long in the body without doing much 
harm. They travel quite through it at times. Pins can usually 
be extracted by their heads. When a fish-hook has plunged its 
barbed point into the flesh, it must either be cut down upon and 
withdrawn, or else the hasp pushed forcibly, so that the barb is 
driven out through the skin and the hook is held by the curved 
portiun. The barb can then be snapped off with a pair of steel 
nippers, or the rest of the hook pulled through after it. 

Splinters or Thorns. These should be removed by cutting the 
flesh above them with a sharp knife and lifting them out. If they 
" fester," this can be hastened by poultices, and the matter let out by 
opening soon with a sharp knife. Do not neglect these small inju- 
ries. They have often produced lock-jaw and death. If the splinter 
is under the finger-nail, and cannot be pulled out, do not waste the 
outside end by picking at it. The nail immediately above should 
be scraped as thin as possible by a piece of glass, and theu the thin 
nail overlying should be split with the blade of a knife, or an 
incision made on each side of the splinter, and the tongue of nail 
between the incision removed, which should expose the upper 
surface of the splinter along its entire course. The restraining 
pressure of the nail upon the foreign body is in this way gotten rid 
of, and at the same time an outlet for the products of inflammation 
is given. 

A piece of lint, wet in water, to which a good deal of laudanum 
has been added, should be applied, and kept wet with it as long as 
may be necessary. 

Veins, Swollan and Bursted. Laboring people, and especially 
women, have what are called varicose veins, when the veins of one 
or both legs become very large and swollen. If let alone, the whole 
leg, and sometimes the thigh up to the groin, becomes more or less 
completely covered with a network of these swelled vessels. After 
long standing, about and toward evening the veins become enor- 
mously swollen, rendering the limb heavy and painful. Very 
commonly the skin inflames on some part of the leg, and an ulcer 
forms. Sometimes, without any ulcer, one of the veins suddenly 
bursts, and the person loses a large quantity of blood, and naturally 
becomes much alarmed. 



Wounds. 243 

How Treated. The bowels should be kept open, that is, moved 
every day, by some of the remedies mentioned hereafter (see page 
340). Then the limb should be swathed in a well-fitting roller 
bandage, as described on page 202. Or, what is better, a carefully 
adjusted lace-stocking should be worn. 

When a vein bursts it may.be immediately stopped by putting 
the finger on the bleeding part, and laying the person down flat, 
either on the ground or on a bed. A little pad of lint is then to be 
put on, and bound fast with a roller, which should first be applied 
upon the foot, and rolled up over the pad and above the knee, or 
higher, according to circumstances. The person should be kept lying 
in bed for a few days, in which time the wound heals, and the pad 
may be removed, having first soaked it for a few hours in a wet 
poultice. A small piece of plaster may afterward be put on, and 
the leg rolled as before. 

Wounds. The Dressing of Wounds. Wounds should never 
be uncovered for the purpose of being dressed until everything that 
is likely to be required during the process is close at hand. 

Old dressings that have become fa* to the surface of a wound 
should never he ptdled off sharply, but should be previously 
loosened by bathing with warm water or by the application of a 
bread poultice. 

Discharges should be cleaned away from the edges of a wound, 
and from the surrounding parts, but the surface of the wound itself 
should be left undisturbed. The attendant should be careful to get 
none of the discharge in his eyes. The utmost cleanliness should 
be observed. 

A soft surgical sponge should be used, or else cotton-wool or tow 
soaked in water. When, as in burns, the wound is extensive, but 
a part of it should be uncovered at once. 

Gunpowder and Gunshot Wounds. Every fourth of July brings 
a rich harvest of these injuries. When they are in the form of 
burns from the flaming up of ignited gunpowder, the treatment 
is the same as that given for other burns. Small shot and grains 
of unburnt powder should be picked out with a small forceps or 
the point of a needle or penknife. The bleeding should be staunched 
as directed under that subject, and the part wounded placed in a 



244 



Accidents, Injuries and Poisons. 



natural and easy position. If there is much shock and prostration, 
the wounded man should not be moved for some time, and aromatic 
spirits of ammonia (twenty or thirty drops in water) or some 
stimulant be administered. Cold-water dressings to the part will 
be found most comfortable. The thirst which soon sets in may be 
freely allayed with cold water. A bone broken by a ball should be 
treated as before described. 

Tom or Lacerated Wounds. These frequently result from 
machinery or railroad accidents, also from nails and hooks. There 
is apt to be in them dirt and other foreign substances. They 
should therefore be carefully cleansed. Strapping, not too tight, 
and light bandaging are very serviceable in them. They are often 
slow to heal. When a finger or limb has been crushed by machinery 
or a heavy weight, an excellent mode of treatment is to keep it 
constantly wet with tepid water, by the "irrigating" plan, which 
has been described on an earlier page. 

Some torn wounds, of not unfrequent occurrence, require modes 
of dressing different from others. A peculiar and important acci- 
dent is a rupture of the ham-string, or, as physicians call it, the 



Fig. 91. 




Dressing Ruptured Ham-string. 



tendon of Achilles. This strong 
sinew is at the back of the heel, 
and in violent efforts at leaping, 
as well as by direct violence, may 
be torn across. The patient 
must then submit to having his 
leg placed in the splint depicted 
in Figure 94. It usually re- 
quires some two months to unite. 



The method of applying the dressing has been so clearly shown by 
the artist that further description is needless. 

Cuts, Stabs, and Thrusts. These are known as incised and 
punctured wounds, and form an important class of injuries. The 
treatment is to remove all dirt, clots, and foreign matter, by the 
free use of water, check the bleeding by some of the means 
already described, then bring the edges of the wound smoothly 
and evenly together, and fiisten them by strips of adhesive or stick- 
ing plaster. 



Cuts, Stabs and Thrusts. 



245 



Fig. 95. 




The use of this plaster deserves special mention. It should first 
be cut lengthwise into strips a quarter of an inch wide. These can 
be cut again crosswise, so as 
to extend across the wound, 
and far enough on each side 
to secure a suitable hold on 
the skin. Warm the plas- 
ter side of the strip at the 
fire until it becomes thor- 
oughly and uniformly melted, 
then, beginning at one end 
(recollecting that the centre 
of the strip should cross the 
incision), rapidly and com- 
pletely attach it to the skin, 
as a rule, at right angles to 
the line of the cut. As the 
middle part approaches the 
wound, with the fingers 
bring up the skin towards 
the incision, from the other side, upon which the other half of the 
strip is to rest; then rapidly attach the rest of the strip. 

If one strip will keep the edges approximated along the whole 
length of the wound, no more is needed. If not, use others. 
Where more than one is used, the edge of the strip should be brought 
across a short distance from the extremity of the. wound, so as to 
permit the ready exit of blood or pus. On the scalp, the face of 
man, and the extremities of some persons, the hairs must first be 
shaved off the skin, or the plaster will not remain attached. 

Most persons, in using adhesive plaster on a wound, apply a large 
piece, or several small pieces, so as to completely cover it. This 
must not be done. A few drops of blood escaping after such an 
arrangement, even when the edges of the wound have been care- 
fully brought together, undergoes decomposition, irritates and 
inflames the parts, loosens the plaster, and changes what otherwise 
should have been the result of the accident. 

Stabs in the chest may penetrate the lungs. When this is the 
21* 



Applying Sticking Plaster. 



Accidents, Injuries and Poisons. 



246 

case, the patient spits blood. The great object is to check this as 
soon as possible. We should inhale the vapor of turpentine, sprin- 
kled on a handkerchief; swallow small pieces of ice; have cold 
applied to the chest ; and, as soon as possible, take five to ten grains 
of gallic acid, and repeat it every quarter of an hour. 

The tongm is sometimes cut with a knife, or bitten by the teeth, 
causing alarming bleeding. This wound cannot be dressed with 
much success. The best step is to wash the mouth with alum-water 
till the bleeding ceases, and leave the wound to nature. 

The throat is often cut in attempts at suicide. Usually, the 
wound is not deep enough to accomplish this desperate purpose 
The treatment is peculiar. Small quantities of nourishment and 
stimulants may be given, but the wound should not be sewed or 
tightly strapped, as the matter accumulating in the wound might 
press on the windpipe and choke the patient. The position of the 
patient is the great thing to attend to. When the bleeding has 
ceased, his shoulders should be raised by pillows, so as to make the 
head bow forward. Hot, moist flannels should be kept to the 
-wound. 

Scalp Wounds are frequent from machinery and from falls, and 
fn >m blows from missiles. If there is con- 
cussion or compression of the brain, these 
sto mid be treated as set forth under those 
headings. The wound should be tho- 
roughly washed by pouring tepid water 
' upon it, the hair should be cut with scis- 
sors close to the scalp, the bleeding stopped 
by pressure or twisting the arteries, or 
by holding a piece of ice to the part, 
and the fragments of the scalp carefully 
replaced and fastened by adhesive straps. 
A bandage should then be applied to the 
head, the pattern for which will readily 
be seen by Figure 96. 
After almost any severe surgical disease 
or injury, "the" limb which has been hurt fails to regain its pliability 
long after the immediate wound is healed. The stiffness and 



Fis 06. 




Bandage for a Scalp Wound. 

Passive Movements. 



Passive Movements. 



247 



soreness, the swelling and the pain on motion, must be vigorously 
combated, or, through indulgence, the joints will become perma- 
nently stiff or "anchylosed," and the muscles dwindle and pass into 
what is called " atrophy." 

To prevent this, the limb should be moved 
to and fro, its surface well rubbed with stimu- 
lating liniment, asNos. 164, 166, or 171 (page 
353), or with the dry hand. Warm and cold 
water may be poured on it from a height alter- 
nately for two or three minutes, morning and 
evening, followed by active rubbing. Electri- 
city and the flesh brush are also in much use in 
obstinate cases, and also kneading and working 
up the muscles, the process called " massage." 
Similar procedures are often very valuable in 
stiffness in chronic rheumatism. 

For all such cases the " Swedish movement 
cure " has been often and justly praised. Its passive Motion of 
peculiarity is that the person is handled and 
moved to and fro by an assistant, instead of moving himself. The 
advantages are that more motion with less fatigue is ensured, and it 
can be more .accurately directed than by the patient's own volition. 
Without entering into the subject to any great 
extent, we illustrate it by showing a few of the 
more prominent passive movements. 

The first is when the patient grasps a bar above 
his head, and the assistant grasps his hips and 
moves his body around in a circle. By this 

Fig. 99. 






Passive Motion of 
the Chest and Ab- 

Passive Motion of Limbs Forward. 
the muscles of the trunk, of the back and the thighs are well 
stretched, and the hip joints rendered more pliable. 



,?48 



Accidents, Injuries and Poisons. 



rig. 100. 



The second motion, displayed in Figure 98, is •where an assistant 
grasps the haDds of the patient, who is upon his knees, and bend- 
ing them backward over his head, puts the muscles of the chest 
and abdomen on the stretch, as well as the joints of the arms and 
the back* 

In Figures 99 and 100 we illustrate the plan pursued in pas- 
sive motion of the lower extremities. Figure 99 shows how this 
is done by a knee and hip motion forward, during which the 
patient can be drawn on one or the other side. Figure 100 repre- 
sents how the muscles and 
joints of the lower extremi- 
ties can be put on the stretch 
backward. 

These few examples will 
give the reader an idea of 
the nature of passive move- 
ments. They are extremely 
Passive Motion of Limbs, Backward. useful after sprains, frac- 
tures and lacerations, after rheumatic and neuralgic attacks, and 
similar ailments which affect the power of voluntary movement. 
Their general principles are evident from what has been written, 
and it will be easy to extend their application as needed. 




Poisons and Poisoning. 

Hardly any accident is more common than poisoning, either by 
intention or by mistake. Often, there are symptoms of poisoning 
when the patient cannot or will not say what it is he has taken. 
Therefore the importance of some 



General Directions for the Treatment of Poisoning. 

1. Make the patient vomit at once. To do this, give him a tea- 
spoonful of ground mustard, in a teacupful of warm water, every 
minute, until he throws up. Or a tablespoonful of common table 
salt, in the same quantity of warm water. Or tickle the inside of 
his throat with a feather or the finger. 



Poisons and Poisoning. 249 

2. After lie has well vomited, let him take the antidote for the 
poison, when any one is given in the following pages. 

3. Rest and quiet, a low diet, and the reclining position, should 
be kept for several days. Barley water (p. 322), linseed tea (p. 
323), chicken broth (p. 326), and such articles, should be the main 
staples of food for a few days. 

Proceeding now to the particular poisons which one is liable to 
be called upon to treat, we speak of them in alphabetical order. 

Acids — Mineral. These are nitric acid, or aqua fortis; sul- 
phuric acid, or oil of vitriol ; and muriatic acid, or spirits of salt. 
Commence with a vomit. Then, give a tablespoonful of lime-water 
(p. 355), in a wineglassful of water, every minute, until the burn- 
ing pain is relieved. Common soap may be made into a strong 
suds, and a wineglassful of this given frequently. 

Alcohol. This, in the form of brandy, rum, gin, whisky, or 
other intoxicating liquors, is a dangerous poison. Persons who 
become "dead-drunk" are liable to be dead in earnest, unless 
restored. Give an emetic, or tickle the throat, to make them vomit. 
Then pour cold water, from a height, on their heads. When awak- 
ened, give five grains of carbonate of ammonia, in a wineglass of 
water, every quarter of an hour. 

Aconite* Called also markshood and wolf bane. Give emetic 
at once, and if the patient is stupid, keep up the breathing by arti- 
ficial respiration (p. 226). This dangerous poison is much used in 
liniments, which are sometimes taken by mistake. 

Ammonia, and other alkalies. By the latter name chemists call 
lime, soda (washing soda), potash, lye, and similar materials. Spir- 
its of hartshorn, or aqua ammonia, is a well-known strong irritant. 
When taken internally, give, at once, table vinegar, by the dessert- 
spoonful, till the pain lessens. Lemon-juice will also answer. 
Olive oil will afterwards be beneficial. 

Antimony. This is contained in tartar emetic, and antimonial 
wine; also in "hive syrup," sometimes used for colds in children. 
It causes violent vomiting. The antidote is tannin or tannic acid, 
nutgalls, or powdered oak bark. A teaspoonful of tannin, in water, 
may be given. A cup of strong green tea is also useful as an anti- 
dote, and is readily prepared. 



250 Accidents, Injuries and Poisons. 

Arsenic. This common poison is found in ratsbane, Paris green, 
fly poison, Fowler's solution, and other familiar preparations. The 
first step is to give an emetic and vomit freely (see p. 345). Then 
the patient should drink plenty of milk, white of egg and water, or 
flour and water. The antidote is freshly prepared hydrated per- 
oxide of iron, which can be had of any apothecary. 

Baryta. This substance, largely used to adulterate certain 
paints, is sometimes accidentally swallowed in poisonous doses. 

The antidote is water, acidulated to about the strength of lemon- 
ade, with sulphuric acid, which converts the baryta into an insolu- 
ble compound, which must be dislodged from the stomach by an 
. emetic. 

Belladonna. Deadly Nightshade. The berries are some- 
times eaten by children. Empty the stomach with an emetic, pour 
cold water, from a height, upon the head, if there is stupor, and 
give ten drops of laudanum, every quarter of an hour, for two 
hours (to an adult, two drops to a child). 

Bismuth. Often used in toilet powders. Give an emetic, and 
when it has acted, copious draughts of milk. 

Bitter-Sweet. Woody Nightshade, Dulcamara. Proceed 
as for belladonna. 

Camphor. Give an emetic, followed by draught* of warm 
water, flaxseed tea, gum-arabic water, milk and the like. 

Copper. Cooking in copper vessels, or allowing acid fruits to 
remain in them, may poison the food. Blue vitriol is a common 
salt of copper. After free vomiting, give milk, or white of eges, 
in water. Ordinary baking soda, or iron filings, a half teaspoonful 
every five minutes, should be given, to the extent of four or five 
doses, if the symptoms are severe. 

Corrosive Sublimate. The bichloride of mercury (corrosive 
sublimate), often used as a solution, in houses, for destroying ver- 
min about beds, is one of the most active poisons, when taken 
internally. The red oxide of mercury (red precipitate) is another 
dangerous salt of the same metal. When swallowed, the white of 
eggs should at once be given, and often repeated. In the absence 
of this form of albumen, common milk can be used, or wheat flour 
beaten up with water. 



Poisons and Poisoning. 25 1 

Digitalis. Foxglove. Treat as for belladonna. Twenty or 
thirty drops of aromatic spirits of ammonia, in water, will aid in 
restoring the strength of the heart. 

Henbane. Hyoscyamus. Treat as given above for belladonna. 

Iodine. The common tincture of iodine, used for external 
application, is the usual form of this poison. Starch, in water, 
may be freely given until vomiting is secured by an emetic. 

Iron, Sulphate of. Copperas, or Green Vitriol. This is an 
irritant poison. After vomiting, let the patient take carbonate of 
soda (baking soda), as recommended for copper poisoning. 

Lead. The form from which poisoning by this substance usu- 
ally takes place is the acetate of lead (sugar of lead). The car- 
bonate of lead, the "white lead" of the painters, and the red oxide 
(red lead), are also sometimes swallowed in poisonous doses. They 
all act as irritant poisons. 

The treatment of such cases consists in giving, as an antidote, 
water, acidulated to about the strength of lemonade, with sulphuric 
acid (oil of vitriol). 

Sulphate of magnesia (epsom-salts), or the sulphate of soda 
(Glauber's salt), in water, are also reputed antidotes. After the 
antidote has been given, in poisoning by lead, an emetic should be 
given. 

Lead poisoning, in the forms of painters' colic, and lead palsy, 
follow from much exposure to the metal. Cosmetics containing 
white lead, and hair-color restorers, containing sugar of lead, water 
which is contaminated by lead piping, and eating food preserved in 
leaden cans, may cause them. The free use of milk will often pre- 
vent these bad effects. 

Mushrooms. When poisoning from eating mushrooms takes 
place, the contents of the stomach should at once be evacuated by 
an emetic. After vomiting has commenced, it should be promoted 
by draughts of warm water, barley water, but particularly by drink- 
ing copiously of warm milk and water, to which sugar has been 
added. 

Nitrate of Potash. Saltpetre. In large doses, say half an 
ounce or more, taken internally, is followed by poisonous symptoms. 
There is pain, with heat in the stomach, vomiting, and purging of 



252 Accidents, Injuries and Poisons. 

blood, with great prostration, and other symptoms denoting the 
action of an irritant poison. 

No antidote is known. The treatment consists in rapidly evacu- 
ating the contents of the stomach by an emetic, and the free 
administration of mucilaginous drinks, with some paregoric, every 
little while. 

Nitrate of Silver. Lunar Caustic. Used in hair dyes and 
indelible ink. The antidote for this violent poison is common salt, 
which acts promptly and efficiently. A strong brine should be 
swallowed as soon as possible. 

Opium. Laudanum, Morphia, Soothing Syrup. This is the 
most frequently used poisonous agent. The first step is to give an 
active emetic, like ground mustard, salt and water, or ipecac. 

The narcotic effects upon the brain, at the same time, as far as 
possible, must be attended to. If the respiration is yielding to the 
poison, that is, falling much below the standard of about twenty to 
the minute, it must be sustained by assistance. The exposed body 
of the patient should be dashed with cold water, not neglecting the 
head, face, and chest. After the cold water has been sufficiently 
used in this way, the body should be dried, removed to a dry spot, 
and hot applications made to the extremities and other parts. This 
is necessary, owing to the heat-producing power of the body being 
impaired by the suspended or diminished respiration. 

If the respiration is not suspended, but is going on at a dimin- 
ished rate, say six or eight to the minute, artificial respiration is 
not required, unless the number of respiratory movements of the 
chest falls below that ; but the other measures may be used. In 
addition to these, a strong stimulant, in the shape of twenty or thirty 
drops of aromatic spirits of ammonia in a tablespoonful of water, 
may be given three or four times, at intervals of a couple or more 
minutes. It is better than brandy, or anything alcoholic, because 
the mode of the action of brandy is much the same upon the brain 
as opium, and it might be rather adding to instead of taking from 
the poison that is at work. The aromatic spirits of ammonia will 
give the advantage, without the disadvantage. A few tablespoon- 
fuls of very strong freshly made coffee is a useful thing to give in 
such cases. 



Poisons and Poisoning. 253 

Among measures to keep in activity the circulation and respira- 
tion, as well as to promote the elimination (casting out) from the 
blood of the poison acting as a narcotic, there are few things more 
useful than muscular exercise. The patient should be walked or 
run up and down the room constantly. 

Oxalic Acid. Often taken by mistake for epsom salts — a dan- 
gerous mistake. Give at once powdered chalk, calcined and 
powdered magnesia, or strong lime-water. After these have been 
administered for a time an emetic will empty the stomach. 

Poison Vine. Poison Oak, Poison Sumac. These are species 
of Rhus, and abound in many parts of the United States. The 
juice, or even the touch of the leaf when the dew is on it, brings 
about in many persons redness, itching, swelling, and blisters. The 
person so affected should take a dose of epsom salts or cream of 
tartar, to empty the bowels, and bathe the parts with lead-wash (p. 
355). A wash of a teaspoonful of baking soda in a tumbler of 
water immediately after exposure will prevent the eruption. When 
the latter has appeared, painting the parts with tincture of iron will 
usually check it. A solution of blue vitriol or sulphate of copper, 
a teaspoonful to the pint of water, is also an efficient lotion. 

Prussic Acid. This substance is so rapidly fatal that little can 
be done to avert death. If possible, give an emetic of mustard, and 
follow with stimulants. 

Phosphorus. Sometimes taken in rat and roach poison, and 
in matches. There is no antidote known. Some calcined mag- 
nesia may be given in plenty of water, to be rapidly followed by an 
emetic, and then an abundance of mucilaginous drinks. 

Savine, Oil of. This substance in large doses inflames the 
stomach and bowels. Give olive oil in tablespoonful doses, and 
empty the stomach with emetics. 

Stramonium. Usually known as thorn apple, or jimson weed; 
belongs to the same natural order in botany as belladonna, and 
when taken internally in improper quantities, is to be treated by 
similar general means. Children often gather the seeds and eat 
them. 

Strychnine. Nux Vomica. This dangerous substance destroys 
life quickly, with severe convulsions. The patient should be made 
22 



254 Accidents, Injuries and Poisons. 

to vomit without delay. Chloroform should then he given in tea- 
spoonful doses, in water, every quarter of an hour. Artificial 
respiration may be tried if apparent death has set in. 

Tobacco. The oil of tobacco is a violent poison, and the leaf 
when swallowed causes nausea and vomiting. This should be 
encouraged with warm water, after which twenty-drop doses of 
aromatic spirits of ammonia, in a tablespoonful of water, will be of 
benefit. 

Laying Out the Dead. 

When a person dies, the eyes should be closed by gentle pres- 
sure with the fingers for a few minutes, or a small weight— a penny 
or similar coin — may be used to keep up the pressure. 

The limbs should be straightened out carefully, and a bandage 
applied under the lower jaw, to support it; the arms should be 
placed by the side, and the lower extremities kept in position by 
means of a bandage connecting the great toes. 

The clothes should then all be removed, and after the body has 
been thoroughly washed, be replaced by a clean bed-gown. 




PART III. 



SICKNESS IN CHILDHOOD. 



THE DIVISIONS OF THIS PART. 

The ailments affecting children, either exclusively or with espe- 
cial frequency, will be spoken of on the same plan as were those of 
adults. But a less rigid adherence to the plan of Part II will be 
adopted, as we shall have fewer maladies to study. The first chap- 
ter of this part, the Seventh of the book, will be devoted to ailments 
affecting the whole body of the child ; the second chapter, Eighth 
of the book, will treat of those confined to parts of its body ; while 
the third, the Ninth of the book, will explain the management of 
the accidents, etc., to which the child is particularly liable. 

By the term " Childhood," in this Part, is not meant infancy, 
that is, the first year of life. This has been already fully treated 
in " The Physical Life of Woman," to which work the reader is 
referred for the management of the newly born and of babes. 
" Childhood," as here used, covers the period from the epoch of 
weaning to that of puberty, and the doses recommended will be for 
children about eight or ten years of age. 
255 



CHAPTER VII. 

Diseases of Children — Ailments Affecting the 
Whole Body. 

Infantile Remittent Fever: (Wasting Fever — Gastric Fever — Worm Fever.) 
Teething Fever. Scarlet Fever : (Scarlatina— Scarlet Rash— Putrid Sore 
Throat.) Measles: (French Measles— Black Measles.) Mumps. Chicken- 
pox, or Varicella. Small-pox, and Vaccination. Chorea, or St. Vitus' 
Dance. Jaundice, or Yellows. Worms, and Worm Troubles. Hydro- 
cephalus, or Water on the Brain. Marasmus: Wasting, or Decline. 
Scrofula: Scrofulosis, or King's Evil— Management of Scrofulous Chil- 
dren—Hygienic Treatment. Rickets, or Rachitis. Fits, or Convulsions. 
Night Terrors, and Excessive Nervousness. 

Infantile Remittent Fever. Known also as Infantile Typhoid, 
Wasting Fever, of children, Worm Fever, Infantile Hectic, and 
Gastric Fever, of infants. 

How Distinguished. Tn this affection, there is always inflam- 
mation of the stomach and bowels. It may come on suddenly, the 
child, though apparently well on going to bed, being attacked soon 
afterward by fever; the skin is hot and dry, the face flushed, the 
eyes red, the pulse quick, the thirst constant, with dry, coated 
tongue, but red at its point ; the child is very restless, and even 
delirious. The abdomen is tender on pressure, and hot, and there 
may be nausea, and vomiting of a sour, greenish yellow fluid. 
These symptoms continue until nearly daylight, when they begin 
to lessen, though they do not disappear entirely until the day is well 
advanced. Even then, there is languor, with great irritability, and 
the symptoms are again observed to be present towards nightfall, and 
the fever thus comes and goes, and may even become of a continued 
form. Often, the child is several days complaining, with thirst, 
hot skin, loss of appetite, fretful, etc., and gradually the disease is 
fully developed. Generally, there is constipation, or diarrhcea may 
256 



Infantile Remittent Fever. 257 

\>e present, with frequent, small passages. All discharges from the 
bowels are very offensive, dark, or clay-colored, tarry, and even 
bloody. In the latter case, there is more or less straining and grip- 
ing. In severe cases, the child lies upon the back, with the knees 
drawn up, and his face shows the distress which he is suffering. In 
protracted cases, the symptoms assume all the more marked 
appearance of typhoid fever. Cough is often present, and from 
this and other symptoms, as the picking of the nose, etc., worms 
are supposed to be the cause of the affection, and hence one of its 
names. 

Worm Fever. The child rapidly emaciates, and becomes much 
debilitated, falls into a stupor, with the eyes half-closed, and pre- 
sents all the appearance of disease of the brain. Or the cough 
develops into a complete attack of bronchitis. The disease is often 
observed to abate its force, and then a relapse occurs, with aggrava- 
tion of all the bowel symptoms. Where there exists a tendency to 
tubercles, these develop, and a fatal result ensues. 

How Treated. It is important that the diet should be mild, 
nutritious, and easy of digestion ; the drinks of cold, mucilaginous 
form (such as given, p. 323). The bowels may be operated on by 
a mild laxative, as rhubarb and magnesia, followed, if necessary, by 
clysters (p. 341), or by castor oil. It should be remembered that 
the bowels are in an irritable condition, and, therefore, they should 
not be unnecessarily troubled. Chalk and ipecacuanha act well in 
small doses, two grains of the former to a quarter grain of the lat- 
ter, and generally cause all the symptoms to improve. Should the 
fever and pain of the abdomen be very great, leeches to the part 
will greatly relieve these symptoms. The warm bath is of great 
value, or the whole surface may be sponged with warm water, much 
to the comfort of the little patient. Applications to the abdomen 
of fomentations, as hops, mush, etc. (p. 346), will aid in the treat- 
ment, and in protracted cases, blisters may be employed, with good 
results. If symptoms of brain affection occur, hot mustard foot- 
baths, cold to the head, leeches behind the ears, become necessary. 
When the discharge becomes offensive, with windy swelling of the 
bowels, turpentine may be given in mucilage, say five to fifteen 
drops, every four or five hours. If the symptoms subside, tonics 
22* 



258 Diseases of Children. 

may at once be employed, as those given, pp. 360 ; 3G1. The 
utmost care must be observed as to the diet, lest indulgence lead to 
a relapse, and every precaution should be taken to guard against 
exposure of the body to cold and dampness. Exercise, at first of a 
passive form, in the open air, should be taken as soon as it can be 
borne, and gradually the patient should be brought back to its 
accustomed habits of diet, exercise, etc. If there remain symptoms 
of enlargement of the glands in the bowels, what are called altera- 
tives, as the syrup of the iodide of iron, ten drops, three times a 
day, will be useful; and this may be aided by rubbing in iodine in 
liniment, or the tincture of iodine may be painted freely over the 

parts. 

Teething Fever, or troubles of dentition. Few children pass 
through the process of dentition without more or less trouble. 
Frequently the general disturbance is out of all proportion to the 
amount of irritation observed in the mouth. 

How Brought On. Dentition is more liable to go on easily and 
safely in cool weather than in the summer season. Coupled with 
the exhausting heat of summer, the evolution of the teeth gives 
rise to a variety of troubles, many of which prove fetal More 
especially is this to be anticipated where the child is of delicate or 
diseased parents, or where it is imperfectly nourished, as by a sickly 
mother, the absence of the breast-milk, etc. 

Sow Distinguished. The surface of the gum is hot and swollen, 
there is more or less running of spittle, the child is fretful, its face 
is flushed, it is constantly working with its fingers in the mouth, or 
bites on anything, as though to relieve the annoyance; at night tbo 
sleep is much disturbed, the bowels are affected with dkrrhoea, 
generally of a mucous character, and there is more or less vomiting. 
In other cases, the skin is hot and dry, the mouth is filled with 
little white spots, aphthae or thrush, and the child is seen eagerly to 
take the breast and in a moment drop it with an irritable cry. 
Under these circumstances, inflammation of the bowels, the brain, 
the stomach, etc., may at any time occur. Most usually, diarrhoea 
results, with great pain of the bowels, rapid emaciation, and an 
aggravation of all the symptoms. Convulsions are extremely liable 
to occur. 



Scarlet Fever. 259 

Hoio Treated. The utmost care should be observed that the 
mother's milk should not be vitiated by excitement, undue exertion, 
improper food or stimulants. 

If the gum is swollen, hot, painful, hard, this condition should 
be relieved by lancing, so as to give free passage to the tooth. 
Often every symptom is at once relieved, and under proper regimen 
the cure is soon effected. Should the fever still persist, unless the 
bowels are free, mild saline laxatives are useful. The thirst is best 
relieved by the free use of cold water. This may also be freely 
applied to the head, and the child will be greatly benefited by 
sponging the whole surface freely, either with cold or tepid water. 
If the diarrhoea be persistent, the astringents, as Nos. 139, 148, 162, 
with chalk mixture, paregoric, or Dover's powder, will soon check it. 
Applications to the abdomen of flannels wrung out of laudanum 
and sweet oil, or hop poultices, will greatly aid in the relief. Con- 
vulsions are best controlled by the application of cold affusions to 
the head, mustard the whole length of the spine, or chloral, the 
latter in a fourth of the dose recommended, page 357. Debility 
must be met at the proper time by cream punch, nourishing diet — 
often this may be in addition to the mother's milk — tonics, particu- 
larly quinine, or tea. of cinchona (page 349). Perhaps, than the 
latter, there is nothing better for debility of the bowels, which often 
occurs with or follows dentition. 

How Prevented. The child should be kept almost constantly in 
the open air, particularly that of the country ; when possible, it should 
be removed from a city residence. The whole surface should be 
kept scrupulously clean ; the clothing should be light and cool ; the 
diet simple ; the bowels carefully regulated ; and the swollen gums 
may be occasionally rubbed with the fingers, or some not too hard 
body. 

Scarlet Fever is known as scarlatina, scarlet rash, scarlatina 
maligna, or anginosa, putrid sore throat, etc. There is no difference 
between scarlet fever and scarlatina ; they are both names for the 
same disease. 

How Brought On. This disease is contagious in the fullest sense 
of that word. Still, many are exposed and escape. Though it may 
attack the same person twice, this is rare. Undoubtedly, it is 



260 Diseases of Children. 

caused by bad drainage. Instances bave often occurred where this 
disease only attacked the inmates of a bouse of wbicb the drainage 
was imperfect, and wbere no possible source of contagion could be 
found. 

How Distinguished. Tbe patient generally, tbougb not invari- 
ably, sbows signs of loss of appetite, debility, fretfulness, beadacbe, 
pains in tbe limbs, bot lever, sore tbroat, and an eruption about tbe 
second day. In some cases, tbe first symptom is a convulsion, 
followed by bigb fever and delirium. Tbe eruption is a diffused 
redness, as if tbe skin bad been uniformly scalded, commencing on 
the face and upper parts, but rapidly extending in a few hours over 
the whole body. On close examination, tbe eruption is found 
to consist of fine points very closely placed. The skin is 
swollen, extremely dry and harsh, with a burning feeling, which 
increases to the touch as the hand is kept upon it. The sufferer 
also feels this like a soreness or burning over tbe surface. The 
pulse is always very quick; the mucous surfaces are equally impli- 
cated, the tongue and throat being inflamed, swollen, sore, and often 
of a dull red color; the thirst is very great, and there is almost 
always delirium, unless the case be extremely mild. The mildest 
cases, known as the simple form, have a moderate eruption, scarcely 
any fever or sore throat. The anginose form is where the throat 
receives the full force of the disease, the inflammation being very 
great, and the part covered with a false membrane, which gives it 
the name of putrid sore throat, because of the offensive discharge 
from it. Tbis form rarely fails to leave bad results, as loss of 
hearing, etc. 

The malignant form is that where the first shock of tbe poison 
of the disease is so great that death frequently occurs in a few hours, 
without reaching the stage of eruption. If tbe eruption occurs, it 
is of a livid or bluish character, and recedes, followed by stupor and 
death. Or, if protracted, there is hemorrhage, diarrhoea, and vomit- 
ing. Death is almost certain. 

How Treated. In tbe first or simple form, nursing is the most 
important point, and tbe avoidance of cold or dampness. The thirst 
and fever may be relieved by the free use of cold drinks, ice (see 
p. 322), and a solution of the acetate of ammonia, with tbe 



Scarlet Fever. 261 

sweet spirits of nitre, a tablespoonful of the former to a teaspoon- 
ful of the latter, in a tumbler of water. Great comfort is procured 
by sponging the surface with tepid or cold water. This may be 
repeated, as indicated by the warmth of the skin, etc. A favorite 
domestic remedy is rubbing the whole surface with lard, or a piece 
of fat bacon. This has the advantage of preventing the intolerable 
paiu and itching from the eruption. Some prefer the use of glyce- 
rine, as more cleanly and less offensive. Better than either is cocoa- 
butter. When the throat is quite sore, leeches may be applied to 
the angles of the jaw, and a variety of gargles are employed, as 
pure cider vinegar and cold water, tincture of chloride of iron, a 
teaspoonful to a tumbler of water, or chlorate of potassa (p. 347); 
or the parts may be freely swabbed or brushed, every few hours, 
with strong solutions of the tincture of chloride of iron, equal 
parts of it and water. Care must be observed lest the debility be 
increased by the neglect of nutrition. The food must be of a 
liquid form, and perhaps nothing can equal milk in disease of any 
kind. Next, beef tea, mutton broth, chicken broth, etc. The 
tincture of chloride of iron acts as a good tonic, and may be com- 
bined, in feeble cases, with quinine, one grain of the latter to five 
drops of the former, in a wineglass of water. In these mild forms 
it is extremely important that the case should be guarded against 
cold or dampness, while at the same time proper ventilation is 
secured. 

The putrid sore throat, or malignant form, often gives no time or 
hope to do anything. The effect of the poison of the disease is so 
depressing, that the system is unable to react ; therefore, the prin- 
cipal indication is to use remedies of a stimulating character, such 
as hot baths with mustard or salt; mustard plasters to the spine, 
the extremities ; heat in every way, as by bags of hot sand or salt, 
bottles of hot water (see p. 347) ; stimulation of the skin by fric- 
tions with strong mustard water. At the same time, stimulants 
may be given inwardly, as sweet spirits of ammonia, whisky, and 
preparations of cinchona. In addition to these remedies, a num- 
ber have been suggested and highly lauded as of great value : thus, 
the sulphite of soda, in a saturated solution, given freely, is a 
supposed antidote to the disease. One remedy requires particular 



262 Diseases of Children. 

mention ; this is digitalis. It is made into an infusion of one 
drachm of the powdered leaves, with twelve tablespoonfuls of boiling 
water. When cold, a teaspoonful is given every two, three or four 
hours, according to age, and the effects produced. At first, the 
remedy is given, including the powder itself, by stirring up the 
grounds; as the symptoms abate, the clear liquor is given, and the 
intervals between the doses are lengthened. The attendants should 
be cautioned to watch the pulse, and if it flags, to suspend the 
medicine. This remedy is well worthy of extended trial. If the 
sulphite of soda were combined with it, its value would be greatly 
increased. 

Should dropsy occur, as often is the case after the disease has 
abated, during the process of " skinning," as it is termed, the kidneys 
should be weli acted on. The uva ursi tea, bitter-sweet tea, juniper 
tea (see p. 348), sweet spirits of nitre, jalap and cream of tartar, 
lemonade freely, every remedy that will cause a free flow of water 
to the kidneys, the bowels and the skin, is proper. To prevent 
dropsy, the patient should be kept in the house, and even in his 
room, for several weeks, until the skin has had time to resume its 
proper condition, and thus be less liable to cause the deposit of water. 

How Prevented. By proper drainage, ventilation, and the avoid- 
ance of the contagion, much may be done to prevent this disease, 
or make it less dangerous. Three drops of tincture of belladonna, 
three times a day, or 10 grains of the sulphite of soda, as often, 
will lessen the liability to the attack. 

Measles is known also as rubeola, French measles, black mea- 
sles, morbili, and may be confounded with roseola or rose rash. 
The latter has no fever or throat symptoms. 

How Brought On. This is due to contagion, and is rarely seen 
to occur a second time. 

How Distinguished. The attack is ushered in by all the evidences 
of a cold. The nose runs, the eyes are red and watery, sneezing 
is frequent, and there is more or less cough. Along with this is 
more or less fever and debility. About the fourth day the eruption 
appears, first on the face, then on the chest and upper extremities, 
finally covering the whole body. It is of a dark red color, not fine 
pointed, and arranged in patches of a crescent shape. The fever 



Mumps. 263 

soon declines, and the eruption fades after three days, being fol- 
lowed by slight scaling of the skin. There is also a soreness of the 
throat, though generally of a mild form. 

French or German measles is also called "rotheln." It appears 
like a mixture of measles and scarlet fever. On one part, the 
eruption strongly resembles the one, while on another, it resembles 
the other. Some regard this as an entirely separate disease, and 
claim that it does not afford any safety against an attack of either 
measles or scarlet fever. 

Black measles is that form when typhoid symptoms occur, and 
the attack is complicated with hemorrhages, etc., and generally 
proves fatal. 

How Treated. The bowels should be acted upon gently, by 
some cooling saline, as Nos. 94 or 100, p. 341 ; then the solution 
of acetate of ammonia may be given freely, with soothing and 
cooling drinks (p. 322), and if the cough and chest symptoms are 
severe, a half teaspoonful of ipecac syrup is well. In very many 
cases, scarcely anything more is required than care and nursing. 
In debilitated cases, and those of a typhoid form, quinine, stimu- 
lants, and nutritious food are required. 

The "rotheln," German or French measles, will require the same 
treatment; it may be followed by dropsy, like scarlet fever, though 
it more closely resembles measles. 

Mumps is also known as parotitis or inflammation of the large 
gland back of the jaw, called the parotid. 

How Caused. This is purely contagious. 

How Distinguished. The patient has a slight fever and uneasi- 
ness, and the gland swells, is red, hot, very painful to the touch. 
The swelling may be so great as to cause difficulty of swallowing. 
It may affect but one side, or both at the same time, or one after 
the other, at a long interval. In the course of six or eight days 
the disease disappears, and the gland is reduced to its proper size. 
In very rare instances, the inflammation may go on to form matter. 
The special point of danger is the great liability to ''metastasis," 
that is, a sudden transfer of the disease from the original seat to the 
testicles, the breasts, or even to the brain. In the latter case it may 
prove fatal. 



264 Diseases of Children. 

How Treated. The greatest care must be taken to prevent 
exposure to cold or dampness, as this is the great cause of "metas- 
tasis." The bowels may be gently moved, a light fever mixture 
given, as the acetate of ammonia, and the parts should be bathed 
with a mildly stimulating liniment, as mustard liniment (p. 353), 
and poulticed, to relieve the discomfort of the patient. Should 
metastasis occur, the effort should be made to cause a return to the 
original seat by stimulants over the gland, and by the same treat- 
ment as above to the new point of inflammation. A very hot 
Indian meal poultice is often effectual. 

Chicken Pox, or varicella. This so much resembles a mild 
attack of varioloid that frequently the two are confounded. Indeed, 
some regard them as identical. It is the result of contagion. 

How Distinguished. The fever, if any, is very slight. There 
is no backache, nor aching uf the bones. The pimples are few in 
number and much scattered ; they fill on the second day, scab about 
the fourth, and fall off quickly, rarely leaving any pitting. The 
eruption is not deep-seated, is never umbilicated or depressed in the 
centre, comes out in successive crops, and does not fill with pus 
or matter. It cannot be propagated by inoculation, and is not in 
the least affected by vaccination. 

How Treated. This disease merely requires the bowels to be 
kept free, the avoidance of cold or dampness, and the use of some 
cooling medicine, as the solution of the acetate of ammonia. 

Small Pox has been fully treated of on another page. It may 
be alluded to here to show the neccessity of vaccination of children. 
An uuvaccinated child, especially an infant, if exposed to this 
disease, is extremely apt to be attacked with the most violent form, 
either destroying its life, terribly marking and disfiguring it forever, 
or even causing injury of vision or blindness. Hence it becomes of 
the utmost importance that vaccination should be performed early, 
say at the close of the second month or the beginning of the third. 
Should the disease be prevalent, vaccination should be insisted on 
at once, even within a few hours of birth Care is necessary in 
the selection of matter; only that from perfectly healthy children 
should be employed For this reason it is better not to use a crust 
given by the parents, as one is unable to know to a certainty all 



Small Pox. 265 

the circumstances attending the formation of such a crust, and thus 
may be the unwitting instrument of conveying serious disease. 
There is no doubt that diseases are thus conveyed, and every pre- 
caution should be taken. A crust should be rejected if the child 
from which it is taken exhibits signs of eruptions on the skin, or 
any other form of indisposition. To prevent positively every such 
undesirable result, the advice is given not to use, nor to let the physi- 
cian use, any vaccine matter which has been taken from the human 
arm, but only that which has been derived from young and healthy 
heifers. This can now be had from any of a number of vaccine 
farms, at the most trifling expense. In this connection it may be 
well to notice the fact that a person liable to cutaneous eruptions 
is almost sure to have more or less breaking out under the excite- 
ment of the vaccination. This should be mentioned, as, otherwise, 
these are attributed to the use of bad matter by the vaccinator. 
In vaccinating, the left arm is preferred, as the one least likely to 
interfere with the pursuits of the person, and it is also preferred 
in children, that some uniformity may be had. The virus is softened 
with water into a creamy consistence, and inserted in the arm by 
scratching with the point of a dull lancet, or inserting it as in a 
pocket beneath the outer skin, or in any way, so that it may be 
brought in contact with the absorbing surface, and thus carried into 
the system. Too sharp an instrument will cause too free a flow of 
blood, which will be liable to wash away the virus. The less blood 
the more sure is the operation to be successful. The part is then 
allowed to dry, and generally about the end of the third day it 
begins to inflame ; a small red pimple forms, which gradually en- 
larges, and when at its height is almost circular, depressed in the 
centre, and surrounded with a bright red ring of inflammation. 
About the eleventh day this ring begins to disappear, the pustule 
dries up and forms a thick, dark brown scab, which falls off about 
the end of the third week, leaving a honeycombed scar. During 
this process there is more or less fever, sometimes mounting so high 
as to cause a convulsion, or delirium. In rare instances, the process 
is delayed beyond the third day, and commences as late as the 
tenth or eleventh day, and runs on to a proper termination. Occa- 
sionally, the inflammation begins at once, and aborts, or fails to 
23 



266 Diseases of Children. 

form a vesicle, a thin scab forms and drops off in a few days. 
This is known as spurious vaccination, and is of no value as a 
preventive. In such cases the operation should be repeated, even 
several times, until the physician is satisfied of the impossibility of 
success. In these instances, it is believed that the patient is not so 
liable to be attacked with small pox, or would be most likely to have 
it in a very slight or modified form. 

Revaccination should always be practiced when small pox is 
prevalent, as the susceptibility appears, in some people, to be renewed 
after a lapse of years, say five or seven years, on the average. 

Chorea, or St. Vitus' Dance, or the Shakes, has been treated 
of on a former page. 

Jaundice, or Yellows, in children, or infantile icterus, is fre- 
quently seen a few days after birth, and generally disappears of its 
own accord, in the course of a week. It appears mostly in feeble, 
delicate infants, and is perhaps due to want of cleanliness, prevent- 
ing the proper action of the skin, imperfect action of the lungs, 
or exposure to cold. In obstinate cases, it may be due to obstruc- 
tion of the bile passages, or even to malformation of these parts. 

How Distinguished. The whole surface of the skin is of a yel- 
low hue, the urine is of a saffron color, and the passages are of a 
light clay color, or even white. 

How Treated. In ordinary cases, a mild laxative, as white wal- 
nut tea, p. 349, with pure air of a proper temperature, and cleanli- 
ness, will be all that is needed, and the coloring will speedily 
disappear. If the case is obstinate, and evidently due to obstruc- 
tion by thickened bile or gall stones, hot baths, fomentations to the 
region of the liver, hot drinks, purgatives, such as No. 94, will 
relieve the case, by removing the obstruction. In the event of 
failure, dandelion tea (p. 350), and nitro-muriatic acid, one drop in 
water, thrice daily, will aid in giving relief. These latter, especi- 
ally the acid, act also to cause the removal of the yellowness, after 
the cause of the affection is removed. 

Worm Troubles are not so common as generally supposed. Al- 
most every irritation or abnormal condition of a child is attributed 
by the parents, and others, to the presence of worms, and the little 
sufferer is often made worse by the resulting medication. With- 



Worm Troubles. 267 

out giving all the varieties of worms, it will be sufficient to allude 
to three kinds : intestinal worms, seat or thread worms, and round 
worms. 

How Caused. In very many instances these are due to improper 
or unhealthy food. Thus, meat of any kind, eaten too raw, may 
deposit the larvae of worms, and thus lead to the production of 
these parasites in the system. Especially is this true of pork, which, 
made into sausage, half cooked, or ham, imperfectly cured, eaten 
raw, is often much diseased, and forms an appropriate nest for the 
deposit of the eggs of worms. Want of cleanliness, as of the re- 
gions near the anus, is generally the cause of seat worms, which 
often pass forward into the vagina, and set up an irritation there, 
causing symptoms of an alarming character. 

How Distinguished. A child is generally supposed to have 
worms when it picks its nose constantly, loses its appetite, or eats 
voraciously; is generally irritable and peevish; is restless at night; 
groaning ; grinding the teeth ; complains of great itching about the 
opening of the bowels. Often there is an irritable, spasmodic 
cough ; and occasionally, convulsions come on, which can be traced 
to no other apparent cause. 

Diarrhoea occurs, of an irregular form, better one day, worse the 
next; the stools are offensive, slimy, and occasionally contain one 
or more worms. Vomiting, also, is often present. Add to this, 
the child constantly losing flesh, having dark rings around the eyes, 
indigestion, sleeping with the eyes half shut, and there is good 
reason to suspect the presence of worms, even when none are 
passed. The thread or seat worms cause a most intolerable irrita- 
tion about the orifice of the bowel, even tenesmus, when a stool 
occurs ; often a white discharge occurs from the vagina, in girls, 
which is due to the presence of seat worms. In the evening and 
at night, more or less fever is present, in severe cases. When the 
tapeworm is present, the most marked emaciation occurs, causing 
the patient to become literally " skin and bone." 

How Treated. First, the worms must be expelled from the 
bowels. This done, the system may be enabled to regain its usual 
tone by the appropriate remedies. Seat worms, and those occupy- 
ing the lower bowel, are generally readily killed and expelled by 



268 Diseases of Children. 

the free use of clysters of salt and water, an ounce to a pint, thrown 
in warm, morning and evening; or of an infusion of quassia; or 
of a solution of the tincture of the chloride of iron, say four 
drachms to a pint of water ; or of lime water. All these, when 
employed, should be thrown into the bowel freely. Their effect 
may be greatly aided by a brisk purgative, as cream of tartar and 
jalap, or seidlitz powder. Of internal remedies, for the other 
forms, a variety are used, and highly praised: as, wormwood tea, (p. 
350); oil of turpentine, ten drops in molasses; pumpkin seed tea; 
and santonine. The latter is of great value, and is given in three 
grain doses, to a child of five to seven years, two or three times a 
day. Recently, the oil of male fern appears to have obtained great 
favor, in this affection. The patient is first purged moderately, and 
kept on low diet; thus preparing the worms for the full effect of 
the medicine; then, in the morning, the oil is given in a dose of 
ten to twenty drops, according to the age, mixed with syrup and 
mucilage. This is followed, in six or eight hours, by a full dose 
of some purgative. One or two doses generally remove all the 
worms, and the cure is completed by the use of tincture of chloride 
of iron, with aloes; or five drops of muriatic acid, with infusion of 
quassia. Pumpkin seeds, also, should be taken on an empty 
stomach, and as they are harmless, they may be used very freely. 
Salt, eaten freely with the food, is also an excellent remedy for 
worms, being both preventive and curative. Iron and cod-liver 
oil will aid in building up the system, and are supposed to act as a 
means of prevention. In no case, however, ought the child to be 
purged and medicated for worms, unless it is quite positive that 
such are present. Rarely do they exist without some evidence 
being shown in the discharges; hence these should be carefully 
examined. 

Hydrocephalus, or Water on the Brain, may be either acute, 
or sudden, or chronic, or gradual in its formation. This is also 
known as dropsy of the brain. Sometimes children are born with 
this affection ; or it may cause their premature delivery, and conse- 
quent death. 

How Brought On. This may be due to brain disease, to general 



Marasmus. 269 

dropsy, to injuries of the head, or it may follow other affections, as 
scarlet fever. 

How Distinguished. The chronic form is often very insidious 
in its approach ; often the brain becomes so tolerant of the pressure, 
that scarcely any impairment of the bodily functions is observed. 
Even, in some, the mental powers seem but little disturbed, though 
generally it results in idiocy long before a fatal termination. Gen- 
erally, convulsions occur, a slight fit each day, with a little twitch- 
ing, etc. The enlargement of the head is scarcely noticed until 
the disease has existed for some time. The child wastes, in spite 
of all the nourishment, which it greedily takes ; it finds the head 
too heavy, and therefore avoids the erect posture ; the bowels are 
irregular; the vision is impaired or lost; crossing of the eyes often 
is early noticed; there may be paralysis, especially of the lower 
extremities, or one-half of the body is affected. 

In the acute form, the symptoms progress with great rapidity ; 
the head rapidly enlarges, the moulds of the head expand and the 
skin bulges out, the child suddenly becomes cross-eyed, stupid, 
lethargic, comatose, and dies, generally, in a convulsion. 

How Treated. But little can be done. The only hope would 
be the evacuation of the water by causing every avenue to carry it 
off. Purging would cause watery stools, but might, if carried too 
far, complete the case by rapidly increasing the debility. The food 
should be of a liquid, highly nutritious form. Absorption may be 
promoted by rubbing iodide of potassa ointment over the whole 
scalp, previously shaven, or by blisters to the back of the neck, or 
to the scalp. Medicines to act on the kidneys may be given, as 
receipts Nos. 137, 147, etc., combined with a tonic. So soon as 
improvement is observed, quinine and iron should be given. 

Marasmus is well known as wasting or decline; its technical 
names are infantile atrophy and tabes mesenterica. 

How Brought On. Many children, especially those who are at 
the nursing age, are observed to lose flesh and pine away without 
any apparent cause. Unfortunately, in too many instances, without 
a careful inquiry, the little sufferers are still further injured by 
dosing with the thousand and one nostrums for children, and thus 
the stomach and bowels are permanently disordered, and digestion 
23* 



270 Diseases of Children. 

is impaired, so that the food which is necessary for the improvement 
of the child only serves to act as a foreign body. 

How Distinguished. Marasmus, to whatever cause it may be 
due, is marked by a slow, constant wasting ; the sufferer loses flesh, 
becomes pale, requires a great deal of rest, exhibits no desire to join 
in the usual infantile sports, and, as the disease advances, it comes 
to look like a little old man, with a wrinkled brow, a head apparently 
too large for the body, limbs that have dwindled away to skin and 
bone. The skin becomes harsh and dry, the appetite is capricious, 
often being so voracious as to cause the attendants to believe in the 
presence of worms, which they think are devouring the food 
intended for the nourishment of the child. When this affection is 
dependent upon wasting disease of the lungs, really a consumption, 
there is more or less cough, expectoration, fever from the middle of 
the afternoon or at night, derangement of the bowels, generally 
constipation. "When dependent upon disease or consumption of the 
bowels, the tabes mesenterica, the bowels are tender upon pressure, 
there are eructations of wind and food, sour stomach, constipation 
aud diarrhoea alternately, fever, but no cough. When dependent 
upon insufficient or improper food, the child is constantly desiring 
the breast, or bottle, as the case may be; it takes the food eagerly 
and ejects it but little altered. 

How Treated. The food should first claim the attention. If 
the child is at the breast, the mother's milk should be carefully 
examined, first, as to its quantity ; second, as to its quality. If the 
supply is small and the child seems never satisfied, it should be 
supplemented by the administration of cow's milk properly prepared. 
Frequently the mode of preparation is by diluting it with water to 
the extent of one-half, or even two-thirds, and thus the child gets 
one pint of milk while taking three times that quantity of fluid, 
filling the stomach and getting but little nourishment. In quite 
young children, the dilution should be one part of water to two 
parts of milk, with sufficient white loaf-sugar to make it rather 
sweet. In older children, the pure milk should be used; and where 
it is difficult to procure pure milk, the condensed milk may be 
employed. Especially is this form valuable in the summer, when 
it is difficult to procure fresh, pure milk, or where the supply is 



Scrofula. 27 1 

liable to be vitiated by keeping. To examine the mother's milk a 
portion should be ^drawn and allowed to stand for some hours, when 
its quality may be judged by the amount of cream formed, and the 
general appearance of the fluid. Milk should always be the nutri- 
ment for the child until the teeth are sufficiently formed to enable it 
properly to masticate the food. Starchy articles may be added to 
the milk, soft-boiled eggs, beef broths, etc., as may seem necessary 
to bring the child up to the normal standard. 

When the stomach is in an acid condition, lime-water, or a little 
bicarbonate of soda, added to the milk, will correct this condition. 
As a tonic and appetizer, some of the bitter infusions are excellent, 
say Nos. 141, 142; or one grain of quinine, three times a day; 
or the elixir of cinchona bark. Where the necessity for an altera- 
tive is apparent, the syrup of the iodide of iron, ten drops, three 
times a day, will give the best results. When the tenderness over 
the bowels shows the presence of intestinal trouble, rubbing the 
abdomen with ointment of iodine, or painting with the tincture, 
will aid in changing this condition. Every day, the whole surface 
should be sponged with tepid salt water ; the skin should be excited to 
its full duty, by brisk frictions with a coarse towel, or a towel dipped 
in salt water, and allowed to dry. Fresh air is of great importance, 
and, when practicable, the child should be removed to the country, 
or to the sea shore. 

Scrofula, or Scrofulosis, is commonly known as the King's evil, 
because it was believed, in ancient times, that the disease could be 
cured by the touch of the king. 

How Brought On. This disease, which is almost solely due to 
hereditary tendency, may be excited to full action by want of 
cleanliness, foul air, deficient or improper nutrition, cold and damp- 
ness. 

How Distinguished. Scrofulous children are generally of a 
pale, flabby appearance, about the face and hands; with light, 
coarse hair; dull in expression; heavy and stolid; thick lips; 
teeth early decayed; large, clammy nose, with wide, open nostrils; 
a tendency to enlargement of the glands, especially of the neck. 
The eyes are weak, easily inflamed, with frequent attacks of in- 
flammation of the lids, and the formation of what are called " styes." 



272 Diseases of Children. 

There is also a great liability to discharges from the nose, and to a 
diarrhoea of a mucous form. Generally, however, constipation is 
an accompaniment. Every sickness occurs in an aggravated form, 
with slow recovery, often becoming chronic. Digestion is extremely 
apt to be impaired by the slightest causes. Extremes of tempera- 
ture are borne with difficulty. Slight injuries produce ulceration, 
with slow or difficult healing. The bones are easily affected, and 
soften or die from trifling causes. Frequently, enlargement of the 
joints takes place, which is with great difficulty reduced. De- 
formities occur, as bending or shortening of the bones, curvature 
of the spine, flattening of the ribs, projection of the breast-bone. 
In short, the whole system evinces a diseased condition, with but 
little recuperative power. Hence, we have scrofulous ophthalmia; 
tabes mesenterica, or marasmus ; slow enlargement of the glands ; 
deafness caused by inflammation of the ear, and the destruction of 
its bones; discharges from the vagina of a thin, unhealthy fluid; 
diseases of the bones; white swelling or scrofulous inflammation 
of the joints; hip disease; spine disease, etc. Lj all these affec- 
tions, there is a marked similarity in the accompanying symptoms. 
The child becomes listless, languid; is disinclined to play, especially 
at anything requiring much motion ; swelling is observed at the 
point at which the disease is about to make its outbreak. The part 
is weak, tender, especially to the touch ; soon, a dull, heavy pain 
commences, an aching pain, increased by motion of the part, and 
also at night, when the patient is in bed. If it is an aperture, as 
the nose or ear, a discharge occurs, of a thin, dirty, yellowish fluid, 
of a very unpleasant odor, generally due to decay and consequent 
discharge of portions of the bony structure. In the joints, great 
enlargement is seen, the ends of the bones forming knobs, and 
consequent deformity, and difficulty of motion. In every instance 
the neighboring glands are early affected, and are felt like hard 
peas beneath the surface. When the nose or throat is affected 
there is more or less coughing, with expectoration of a foul mucus, 
which causes nausea, loss of appetite, even vomiting. An exami- 
nation shows the tonsils greatly enlarged, filling up the throat, 
interfering with the aperture of the inner ear, and thus causing 
more or less deafness. In these cases the child is observed to suf- 



Scrofula. 273 

fer from deafness and difficulty of swallowing in every spell of 
damp weather. 

Scrofulous children are also extremely liable to be affected with 
eruptions of all kinds, particularly during the progress of teething, 
and if they are caused to dry up suddenly, the disease breaks out 
elsewhere, in a more dangerous form. 

When a discharge occurs from the vagina, in a child, it is very 
apt to be regarded as the result of something else, as of an attempt 
at rape ; for this reason great care should be observed, lest a wrong 
be done, and an innocent person suffer. The history of the child 
should be carefully learned, its predisposition, its tendencies, if any, 
to such discbarges elsewhere. In this connection, it should not be 
forgotten, as intimated on a previous page, that the presence of 
seat worms in the rectum, or their transfer to the vagina, will often 
cause discharges from the vagina. 

When a child begins to fail, without apparent cause, the abdo- 
men should be carefully examined, and if found swelled, tender on 
pressure, the limbs emaciated, the glands of the groin and those 
of the abdomen enlarged, as may be ascertained by careful manipu- 
lation, scrofulous disease of the mesenteric glands may be known 
as the cause of the trouble. 

In scrofulous disease of the spine, almost the earliest symptoms 
are a tendency to stumble, a clumsiness, frequent falling, a tendency 
to cross the limbs involuntarily, both in walking and lying down. 
The power of walking is soon lost, especially if the diseased bones 
be low down in the spinal column. When high up, as about the 
neck, the child is observed to support its head on the hand, or on a 
table or other convenient support, and the head begins to sink between 
the shoulders. The bones project, and are tender on pressure, the 
muscles of the spine are wasted, and speedily curvature is observed, 
the affected bones being the point of departure from the true line. 
This may produce pressure upon the cord and. paralysis of the 
corresponding parts, or it may result in what is known as anchylosis, 
or stiffening of the joints at the seat of the disease, leaving the 
patient more or less crippled. 

How Treated. A patient of a scrofulous tendency requires con- 
stant care. It must be placed under the best possible influences 



274 Diseases of Children. 

as to pure, fresh air, cleanliness, sunlight, food, exercise, clothing. 
A child properly protected by warm clothing, kept in the open 
air as much as possible, and properly nourished, will often be 
enabled to recover from such a tendency, and escape the results of 
its constitutional taint. Fresh air and sunlight are of great im- 
portance, and are sure to prove valuable factors in improving the 
general health of a scrofulous patient. Nourishment, in proper 
quantity and form, forms an additional and valuable aid. For 
the young child, milk, and especially that of a good, healthy 
nurse, is the first and best form of food. Later, to cow's milk may 
be added vegetables of easy digestion, and animal food. Soft- 
boiled eggs are generally acceptable to the stomach, and materially 
aid in the nutrition. Much depends upon the cooking, as the best 
food is not easily digested when either too much or too little cooked. 
As indigestion is a frequent accompaniment, the food preparation 
often increases the trouble. In addition to this, care should be 
observed lest the food be taken in too large quantities, and this is 
too often the case as convalescence occurs, and thus the progress to 
health is retarded or prevented. 

A point frequently lost sight of is the drinking-water. In the 

vicinity of large cities, and particularly in their crowded streets, the 

water used is often very impure, and frequently is itself a carrier of 

disease. This is at the present time attracting the attention it deserves, 

and it is hoped will soon lead to an improvement which has long 

been needed, and which will greatly aid in the prevention of disease. 

It cannot be too forcibly impressed upon the attention that those 

who are weak and delicate require pure, fresh air as a necessity, 

even more than the healthy. It bas so long been the rule to confine 

such persons to the house, as though the outer air were poisonous, 

that it often requires the most earnest injunctions on the part of the 

physician to obtain obedience to his orders. House ventilation is 

avoided, from the mistaken idea of giving the child cold. It should 

be thoroughly known that fresh air can do no harm, so long as it is 

supplied without a draught. This may be accomplished in a variety 

of ways, as by partially opening a window, and interposing a screen, 

as a chair with a shawl thrown over it, to prevent the direct current 

of air. Overcrowded apartments must be strictly interdicted, 



Scrofula. 275 

whether by night or day, in the dwelling or the workroom. When 
possible, the patient should be removed to a healthy locality, an 
atmosphere of a dry and elevated situation, in the country or at the 
sea-side. Exercise in the open air must be regular, and never 
omitted except in the most inclement weather. This may be on 
horseback, in an easy carriage, walking, etc. If so arranged as to 
be combined with pleasant recreation, so as to aid in the develop- 
ment of the muscles, greater benefit will be obtained. Fatigue 
should not be allowed, hence the sports, etc., must be watched and 
controlled, to prevent excesses. 

Bathing is a valuable adjunct, keeping the skin in proper condi- 
tion, and thus enabling it to throw off disease. If the patient is 
easily chilled, warm bathing is preferable, and promotes the 
circulation. Otherwise, the tepid bath may be employed. Sponging, 
followed by friction with coarse towels, or towels dipped in salt- 
water and allowed to dry, is very useful. When at the sea-shore, 
bathing must be practiced, but its results must be watched, lest a 
chill follow, and thus undo all the good accomplished. 

Rarely is the cold bath of service. Almost always it is followed 
by a want of reaction, causing more or less congestion of the more 
delicate organs, and hence it proves positively hurtful. With 
some, a cold bath daily, to an infant, is regarded as a means of 
invigoration, a hardening process, which too often results in the 
death of its victim. 

It is pleasant to know that fashion is at last becoming more 
reasonable, and permits her votaries to dress their children according 
to the dictates of good sense and propriety. The child should be fully 
protected against chilliness, especially in a climate liable to sudden 
changes. In summer, the clothing should be light, avoiding either 
extreme, as often a child is kept in a state of perspiration in warm 
weather for want of a little attention. Flannel next the skin, pro- 
tecting the chest and bowels, should be worn until the warm weather 
has fully set in, and then should be substituted by some of the finer 
textures until all danger of sudden changes are past, or these may 
be continued during the balance of the year. 

As to medicine, this must be a last resort, and at first should be 
of the mildest nature. The bowels should be regulated by mild 



2j6 Diseases of Children. 

aperients, or, when indicated by clay-colored passages, those which 
arouse the liver may be employed, such as small doses of rhubarb, 
magnesia, calomel, blue pill, senna, or jalap. 

To improve the digestion, the blood, etc., some form of iron will 
be of value, and here it will be important to find, by observation, 
which preparation is most appropriate — the syrup of the iodide, ten 
drops, three times a day, the tincture of the chloride, five drops, 
three times a day, the potassio tartrate (p. 361), or the pure pow- 
der of iron. Either of these may be combined with quinine, or 
cinchona, as in its agreeable form of elixir, which is most readily 
taken by children. Symptoms must be met as they arise. If the 
bowels are loose, the solution of the logwood tea (p. 348) will be 
an excellent remedy, aided, when required, by paregoric, etc., and 
fluid nutrition in proper amounts. 

If the bowels are much affected, a special point will be the 
avoidance of exercise and the upright position ; rest, in bed, is of 
the utmost value in the treatment of all forms of diarrhoea. But 
frictions to the entire surface, once or twice each day, should not be 
omitted. 

The appetite may be restored by the use of mild bitter infusions, 
as chamomile, columba, or cinchona. Animal fats are highly useful 
in such cases. Hence the value of cod-liver oil ; and if to this we 
add the syrup of iodide of iron, or some other of the preparations 
now so happily prepared by the skill of the chemist, the results 
will be still more beneficial. Such remedies require many months 
to obtain their full and lasting effects. 

In enlargements of the glands of the abdomen, added to the above 
treatment should be the application of iodine to the surface; this 
may be by the use of the tincture, or of the ointment. 

The same may be said of enlarged joints, with the addition of 
perfect rest of the part. 

Recently a variety of remedies have been introduced, as iodized 
milk, made by dissolving one part of iodine in ten of alcohol, and 
mixed with ninety of fresh cow's milk. 

All enlargements of glands may be painted with the tincture of 
iodine, or coated with the iodine ointment. In inflammation of 
the bones, an ointment of carbonate of lead, freely applied over the 



Rickets. 



277 



seat of disease, often acts to arrest its progress. Burdock tea (p. 
349) is an old and valuable domestic remedy in this complaint. 

Rickets, technically known as Rachitis, is a want of nutrition 
of the bones and muscles, causing bending or breaking of the bones 
from slight injuries; muscular weakness ; crooked limbs; curvature 
of the spine; nervous irritability; general tenderness, etc. 

How Brought On. Perhaps the usual cause of this disease is 
want of food, or food of improper kind. It would also appear to. 
be the result of bad ventilation, and want of sunlight. A distin- 
guished observer declares "that wherever the rachitic child is 
dependent upon the mother's milk, the mother will be found to 
have menstruated during lactation, regularly, for several months, 
and the degree of rachitis to be in direct ratio to the frequency, 
duration, and amount of the menstrual flow." In short, the dis- 
ease is the result of anything which impairs nutrition. 

How Distinguished. Children with a tendency to rickets 
exhibit in their whole bony structure unmistakable evidences of 
the disease. The face is broad and square; the head is large and 
flat ; the moulds or openings in the skull do not close until late ; 
the veins are prominent ; the spine is curved ; the limbs, especially 
the lower extremities, are bowed, shortening the child so as to give 
it a squat appearance ; the muscles are feeble ; the child is generally 
deficient in vigor, mental as well as physical ; the skin is thick, and 
of a dirty appearance; the teeth are late in appearing, and the 
child rarely can walk, or even stand, until long after the usual time. 
The child is spiritless, dull, languid; the appetite is poor; the flesh 
is flabby ; the passages from the bowels are loose, dirty-looking, and 
offensive; perspiration occurs at night, and often this is excessive; 
the child gains no power over its muscles, and requires help in all 
its movements, though at first the muscles do not seem wasted, and 
preserve their contour. As the disease advances, the mental and 
physical powers retrograde, and a glance at the child, with its defi- 
cient mental powers, its crooked limbs, unsightly joints, and the 
shape of its chest, shows the whole trouble. 

The glands often become enlarged, as in its congener, scrofula, 
but are softer, much larger, and not so easily moved as in scrofu- 
lous cases. The disease may last from one to three years, and 
24 



278 Diseases of Children. 

under proper treatment, and surrounding circumstances favoring, 
may be completely cured; though, when brought under treatment 
at a late period, deformity, to a certain extent, is liable to remain, 
particularly curvature of the spine, etc. Death occurs from 
exhaustion, the powers of vitality being unable to carry the system 
to a favorable termination ; or death may ensue from some compli- 
cation, as hydrocephalus, diarrhoea, convulsions, incurable changes 
in the larger glands, as the liver, spleen, etc. 

Row Treated. With a full knowledge of the causes inducing 
this affection, and of the nature of its changes, it is easily under- 
stood what would be the special line of treatment. In the early 
stages, when the patient is so fortunate as to come under the proper 
observation, much may be done to prevent its full development, and 
ward off the possible complications. The nourishment must be 
positive, and easy of digestion. The greatest care must be observed, 
to see that food is given at proper intervals, and in sufficient quan- 
tity, as well as of a proper kind. Too much stress cannot be laid 
upon the value of pure cow's milk for children, after weaning, or 
in the event of a failure of the breast-milk. Of course, the 
mother's milk, or that of a healthy young person, is to be preferred 
in all cases where it is possible to be obtained. 

Combined with milk, other articles are valuable, as eggs, in the 
form of custard, or soft-boiled, rice, farina, corn starch, roasted 
potatoes, meats, etc. The same observations apply here as in re- 
gard to scrofula, as the great point is to remedy the difficulty by 
properly nourishing the bones, etc. 

All exhausting discharges, as diarrhoea, etc. ; all complications, as 
indigestion, constipation, etc., must be met as they arise, with the 
appropriate remedies heretofore indicated. The constitution must 
be toned up, strengthened, by tepid baths, sea-bathing, fresh air, 
always that of the country or seashore, if obtainable; tonics, as 
the preparations of iron, particularly those mentioned under that 
head, in Part IV ; cod-liver oil ; bone itself, as fine filings of fresh 
bones, in milk or rice-milk. Blackberry root tea (p. 349), or mag- 
nesia and rhubarb (p. 348), or chalk mixture, will generally relieve 
the diarrhoea; and if the stools are very offensive, castor oil may 
be given to cleanse the bowels, and then the vegetable astringents 



Fits, or Convulsions. 279 

mentioned (p. 348). A valuable aid in changing the character of 
the evacuations, is the addition of a few drops of the solution of 
chlorinated soda to each dose of the diarrhoea mixture. Quinine, 
in combination with iron, as the potassio-tartrate of iron, in cin- 
chona tea (pp. 361, 349), or the tincture of the chloride of iron, 
acts well as a tonic. In many instances, the dilute acids combined 
with a bitter, act well in toning up the muscular system. Thus, 
the dilute nitro-muriatic acid, two to five drops, in gentian, columba, 
cascarilla, or cinchona tea, checks the excessive perspiration, 
strengthens the digestion, and, in fact, improves the whole system. 

Occasionally, when the treatment is commenced at a late period, 
rest will become necessary, to prevent curvature of the limbs 
becoming greater, or great deformity of the spine, resulting from 
the softened condition of the small bones comprising the spinal 
column. This rest must be in a recumbent position, but must be 
combined with daily excursions into the open air. Or some form 
of apparatus may be employed to support the part until the bones 
have acquired sufficient hardness. Thus, when the seat of the 
affection is at the bones of the neck, the weight of the head may 
be taken from the bones by means of an appropriate sling, suspend- 
ing the head from a bowed piece connected with an apparatus 
placed around the chest. Each deformity, or tendency thereto, will 
require its own apparatus, varied to meet the indications. 

How Prevented. A child manifesting a tendency to rickets 
should be kept from an erect position, or the early use of its feet, 
until the bones have assumed a proper degree of hardness. Vio- 
lent exercise, in older children, should be interdicted. Cleanliness, 
ventilation, full nutrition, are the prerequisites for the prevention 
of this affection, as well as the aids in its cure when it is estab- 
lished. Sunlight deprivation is too often a main exciting cause of 
this, as well as other diseases of children. Hence, our legislators 
would show their wisdom by prohibiting the building of houses, as 
dwellings, in the rear of tall factories, as well as upon streets of 
such narrowness as to preclude the entrance of the sun's rays, if at 
all, but for a short period of each clear day. 

Fits, or Convulsions, Spasms, as they are often called, are 
always symptoms of some other affections. 



280 Diseases of Children. 

How Brought On. Fits are very frequently the result of a 
loaded stomach, or a stomach containing articles either of difficult 
digestion, or wholly inappropriate for the action of the stomach's 
powers. Thus, hard-boiled eggs, heavy fruit-cake, minced pies, 
sour milk, nuts of all kinds, raisins, seeds and rind of fruits, sweet- 
meats, food in lumps or imperfectly chewed ; in short, anything 
which, by its imperfect solubility, taxes the powers of the stomach, 
is apt to create so much irritation, by its presence, as to cause a 
reflex excitement of the brain, and the production of convulsions. 

Again, in the beginning of some diseases, as measles, scarlet 
fever, small-pox, the first blow of the poison of the disease may be 
so overwhelming as to cause a convulsion. 

Again, the progress of teething may be so difficult, and accom- 
panied by so much nervous excitement, that convulsions result. 
Worms in the bowels are often regarded as the cause of convulsions, 
but these parasites are more frequently developed by the causes of 
decline in health which are themselves the exciters of the convul- 
sive tendency. Impure air, air loaded with gas from a broken 
stove, or filled with emanations from a foul well, may be the excit- 
ing cause of disease, which is first manifested by a convulsion. 
Cold and dampness, by driving the blood from the surface and the 
extremities, and thus causing congestion of the spine and brain, 
may cause spasms. Fright, great mental emotion, suckling during 
a fit of passion, or other emotion, of the mother, may cause an 
attack of convulsions. 

In some children there is observed a tendency to be attacked 
with convulsions from the slightest causes. In such cases, every 
form of disease is attended with fits. Some seem to inherit this 
tendency from an epileptic parent. Such cases, sooner or later, suc- 
cumb to brain trouble, or grow up deficient in mental capacity. 

How Distinguished. An advantage is gained in the treatment 
when it is possible to learn the cause of the convulsion, by the 
removal of which the attack may be relieved, or its recurrence 
prevented. The history and surroundings of each case will lead to 
a full understanding. Thus, convulsions occurring at holiday times, 
or on festive occasions, or soon after eating, will generally tell their 
own story. Here, the face is flushed, the head throbs, and there is 



Fits, or Convulsions. 281 

every indication of a loaded stomach. The child has been eating 
freely of a mixture of indigestible food, has been complaining of 
sick stomach, has shown signs of irritability and peevishness, per- 
haps has been sleeping in a disturbed way, when suddenly the con- 
vulsion occurred. 

When due to teething, the state of the gums readily aid in ascer- 
taining the cause, these being puffy, swollen, red, tender to the touch. 

A convulsion occurring without any, or scarcely any, premonitory 
symptoms, would lead to the anticipation of an attack of some 
disease, as measles, scarlet fever, small-pox, especially when such 
diseases are prevalent and are occurring in the vicinity. 

How Treated. The treatment must be directed, during a con- 
vulsion, to the shortening of it, and care in preventing injury to 
the head or limbs by the struggles. All tight clothing should be 
loosened, or better, entirely removed. The child should then be 
placed in a warm bath, to which mustard may be added ; during this 
time cold should be applied to the head, either by cloths saturated, 
or by the douche, or by the use of a bladder filled with crushed ice. 
Should this fail to relieve the spasm, the child should be placed 
upon a couch, and a mustard plaster placed the whole length of the 
spine, extending on either side for an inch or two. A decided 
impression must be made before this is removed. If there is reason 
to believe that foreign matters in the stomach are acting to prolong 
the attack, a brisk emetic, ipecacuanha, tartar emetic, sulphate of 
zinc, should be given, and its effect encouraged by the use of 
draughts of hot water with salt or mustard. Injections should be 
thrown into the bowel, of salt and hot water, castor oil, oil of tur- 
pentine, to stimulate the action of the bowel, and act as a revulsive 
to draw the blood from the brain. In obstinate cases, convulsions 
may be broken up by inhalation of ether or chloroform. In rare 
cases, with a strong tendency to a return of the convulsions, the 
effect of these drugs may be continued until all such symptoms 
disappear. Of course, it would scarcely be necessary to make the 
artificial sleep very complete, only sufficient to control the convul- 
sion. Chloral, by injection into the bowel, certainly has proved 
of value in these cases ; a teaspoonful in a pint of water, of which 
a gill may be thrown up in a child of ten. 
24* 



282 Diseases of Children. 

In the interval, or after the spasm has gone off, the indication 
will be to prevent its return and relieve any accompanying symptoms, 
or treat whatever disease may be thus ushered in. The bowels 
should be freely moved ;. the stomach thoroughly emptied, the teeth 
lanced, if necessary ; restlessness subdued by narcotics, as, above all, 
chloral. Worms may be expelled by the appropriate medication ; 
fever lessened by sponging with tepid water, and cold applications 
to the head ; the force of the circulation diminished by small drafts 
of digitalis tea, a teaspoon! ul of the leaves to a quart of water. If 
there are marked evidences of a fullness of blood in the brain, 
leeches behind the ears, to the nape of the neck, or temples, will 
rarely fail to give great relief. In obstinate cases, a blister to the 
back of the neck, extending up and down, and allowed to draw well, 
will prove of great benefit. 

Other complications should be met as they occur, and treated in 
accordance with the principles laid down. 

Night Terrors, and excessive nervousness, are of frequent 
occurrence in childhood. Frights to children often terminate in 
convulsions, imbecility, or death. Those who have the care of 
children should be especially on their guard to use every endeavor 
to prevent frights, and to protect against the foolish habit of 
working on the fears of a child to make it behave properly. Not 
only is this very injurious, but it is liable to make children deceivers 
and liars, and its evil results often cling to them when grown to 
adult age. On the contrary, children should be kindly encouraged, 
and made to feel the protecting care of those around them. They 
should be constantly shown the absence of all danger. 

A child will often suddenly awake in the night, with a frightened 
cry, and evidently impressed with a vague fear of something, and 
fail to recognize the presence of its protectors. This may last for 
several minutes, terminating in a fit of weeping, or it may again 
quietly fall asleep. Such attacks may occur nightly, or at irregular 
intervals. Rarely is it observed to return the same night. These 
are almost invariably the result of some irritation of the stomach or 
bowels, and are generally associated with constipation. 

There is no reason to regard these symptoms as indicative of 



Night Terrors. 283 

brain disease, though a continuance might eventually lead to serious 



How Treated. On the occurrence of such an attack, the child 
should be at once attended to, and in no case is it justifiable to seek 
to quiet it by harsh words or treatment. Its position should always 
be changed by turning it from the back, which is mostly its 
position during such an attack, to the side, or better, by raising it 
in the arms, and thus endeavoring to soothe and comfort it. Or it 
may be roused by washing its face with cold water, and a sup of 
cold water will generally be desired and prove refreshing. The 
child should not be allowed to nurse, which is the usual panacea of 
all infantile troubles, until it is thoroughly roused and quieted. 

To prevent a recurrence of these attacks, the bowels should be 
carefully regulated. All excitement, particularly near the hour of 
sleep, should be carefully avoided. Exercise of a violent nature is 
never otherwise than hurtful, particularly, as is too often the case, 
about the bed-hour. A light in the room, and better still, the 
presence of an attendant, at least for some time after it retires, will 
greatly conduce to the prevention of these alarms. Care should 
always be had not to rudely waken a child from its rest, but in 
every way to promote sleep. This great restorer is needed by the 
child, who plays and labors with all its powers during its waking 
moments, and hence requires plenty of quiet sleep. 

Perhaps the bromide of potassium may prove of value should an 
attack continue obstinate. Opiates, or the so-called soothing syrups, 
should be avoided, as sure to prove hurtful. The dose of the 
bromide of potassium for this purpose should be five or ten grains. 
Eating a raw onion just before bed-time will, with many persons, 
induce refreshing sleep. A glass of hot water (not warm, but hot), 
flavored with lemon or orange peel, has the same effect. Hop tea 
is another pleasant and efficient remedy for sleeplessness. Any of 
these may be tried, and where one fails another will be a success. 



CHAPTER VIII. 

Ailments Affecting Parts of the Body. 

Snuffles— Stomatitis— Thrush— Sore Throat— Croup— Diphtheria— Whoop- 
ing Cough — Coughs and Colds in Children — Infantile Pneumonia— Colic 
— Summer Complaint — Falling of Bowel — Bed- Wetting — Weaning 
Brash— Milk Crust. 

Snuffles, Catarrh of the Nose, Chronic and Acute Ozaena. 

How Brought On. This affection is of quite frequent occur- 
rence in children, infants particularly, and is the result of careless 
exposure to draughts; dampness; imperfect drying after washing; 
want of care as to the clothing, as the exposure of the arms to the 
shoulder, by the foolish fashion of short sleeves, or the equally 
senseless and careless action of standing at a door with the little 
cues head uncovered. 

Huic Distinguished. The attack commences by a constant sneez- 
ing; soon a little fever comes on, with watery eyes, and a thin dis- 
charge from the nose. The nostrils are more or less obstructed, and 
hence the peculiar noise in breathing which originates the name. 
Generally, when sleeping, the child lies with the mouth open, in 
order to breathe. In severe cases, the nostrils are so much ob- 
structed as to interfere with the operation of sucking, and the child 
grasps the nipple, draws, and lets go in order to breathe. Hunger 
incites it to seize the nipple again, and again it is compelled to de- 
sist, and gives vent to its irritation in angry screams. Indeed, this 
may be carried so far as to cause debility and exhaustion. 

Ozaena occurs in children of scrofulous or syphilitic taint, and is 
characterized by all the above symptoms, with the addition of a 
highly offensive and dirty discharge from the nostrils. 

How Treated. In mild cases, care as to clothing, and a proper 
284 



Stomatitis. 285 

degree of heat, will generally be followed by a complete cure in a 
few days. 

In severe cases, debility must be prevented by spoon-feeding, the 
use of tonics, as quinine, iron, and even stimulants. The nostrils 
may be much relieved by the application, with a brush, of soothing 
articles, as cold cream, lard, glycerine; and if false membranes 
form, injections of alum, ten grains to the ounce of water; or 
nitrate of silver, two grains to the ounce, will aid in destroying 
them. 

Where a scrofulous taint exists, the appropriate treatment must 
be used, as the syrup of the iodide of iron, the mercurials, in very 
small doses, etc. 

Stomatitis, Nursing Sore mouth, or Inflammation of the Mucous 
or Lining Membrane of the Mouth, is of quite frequent occurrence 
in childhood. The mild form is most frequent, but occasionally 
ulceration takes place, and rapidly runs into gangrene. This affec- 
tion is generally the result of a weak condition, as in delicate or 
scrofulous children. 

How Distinguished. Generally, the trouble is first observed by 
the child having a difficulty in sucking ; the saliva flows freely ; as 
the nurses say, the child is " constantly slobbering;" the glands 
under the jaw are apt to be tender and swollen. There is more or 
less fever and restlessness ; the appetite is poor ; and there is pain 
on swallowing. Diarrhoea often accompanies this affection. An 
inspection of the mouth shows the presence of many small, white 
spots on the tongue, the whole of the mouth, and even the throat. 
Ulcerations soon occur at these points, and they are coated with a 
dirty, yellow covering. The points may remain separate, or they 
may run together, in which case it becomes a serious matter. In 
the severe cases, the gums are so ulcerated as to fall away from the 
teeth, and expose them ; the mouth is hot, the breath highly offen- 
sive; the lips swollen. Should it continue, the parts assume a 
dark, livid color, the teeth fall out, the inside of the cheeks ulcer- 
ate through, exposing the cavity of the mouth, and the child gene- 
rally dies from exhaustion. 

How Treated. In mild cases, by securing cleanliness, ventilation, 
pure, fresh air in abundance, and proper food, no other treatment is 



286 Diseases of Children. 

required. Many believe that the diarrhoea is due to the same condi- 
tion occurring in the whole of the intestinal tract. No medicinal 
treatment is so directly useful as the chlorate of potassa. This is given 
in doses of two or three grains in sweetened gum water every four or 
five hours, say for a* child of one year, and may be mixed with 
sugar and water. The mouth should be carefully kept clean by the 
use of washes of slippery elm infusion, or flaxseed ; acidity should 
be corrected by lime water, soda, or magnesia. Sometimes, it is 
requisite to employ locally an astringent solution, as the acetate of 
lead, two to four grains to the ounce of water, and this is best 
applied by means of a brush. Occasionally, the nitrate of silver, 
two or three grains to the ounce, or the sulphate of copper in the 
same strength, are required, to stimulate the ulcers to heal. Should 
similar ones appear at the verge of the bowel, as sometimes is seen, 
the same remedies will prove beneficial. The diet must be carefully 
attended to, and the nurse changed, if requisite. Quinine and iron 
should be given if great debility exists, the best forms of which 
have already been mentioned, and the breast milk supplemented by 
broths, milk, and lime water, wine whey, etc. 

When gangrene occurs, it is called "canker," or cancer of the 
mouth; this is generally only seen in children of a broken down 
constitution and of depressed vitality. It often follows low forms of 
fever, scarlet fever, measles, small pox, and is invariably attributed 
to the use of mercury by the physicians. 

But little hope can be indulged as to a favorable result. The 
ulcerative process must be checked by the application of a powerful 
caustic ; the best is the pure hydrochloric acid, carefully touched to 
the surface of the slough or canker by means of a brush, and again 
applied after an interval of twelve or fifteen hours, unless the progress 
is checked. The offensive condition of the mouth may be remedied 
by frequent washings with a proper strength of the solution of the 
chlorinated soda, one part to twelve of water, or a solution of the 
hydrochloric acid, two or three drachms to half a pint of water. 
Of course, the chlorate of potassa must be freely administered, with 
quinine or cinchona in some form, and full nutrition and stimula- 
tion, as needed. 

Thrush, or "aphthae," is also the result of impaired nutrition 



Sore Throat. 287 

and want of vitality, and is most commonly met with in children 
which are hand-fed or suckled by an unhealthy nurse. 

How Distinguished. The child is fretful, attempts to feed, but 
leaves off as if in pain. The bowels are generally disordered. The 
mouth is covered with minute white spots, like specks of curdled 
milk. The whole lining of the mouth is dry, hot, and red. There 
are fever, depression, and in rare instances, swelling of the glands 
and offensive discharges from the bowels, followed by death. 

How Treated. The first point will be the improvement of the 
food, which alone will, in many instances, suffice to cause a cure, if 
continued, with careful attention to the hygiene. The mouth may 
be carefully sponged with pure, cold water, after each taking of 
food, followed by the use of a solution of borax, twenty to thirty 
grains to the ounce of water. Some prefer the sulphite of soda, 
sixty grains to the ounce of water, and claim for it the very best 
results. Others use gargles and mouth washes of chlorate of po- 
tassa, alum, acetate of lead, and in severe cases, the nitrate of 
silver (see pp. 362, 363). Rhubarb and magnesia will act altera- 
tively, and when there is weakness, tonics, as quinine, and some of 
the mineral acids, are valuable. 

Sore Throat, or Swelled Tonsils, generally occurs in children 
of relaxed and scrofulous tendency, and is the result of exposure 
to cold and dampness, or may become chronic. 

How Distinguished. The child swallows as if the act were pain- 
ful, and if old enough, complains of having a sore throat. The 
throat, on examination, is red, and one or both of the tonsils are 
swollen, so as to materially encroach upon the passage. There is 
more or less fever. If not relieved, the symptoms are aggravated, 
the pain is intense and throbbing, the throat seems about to close 
up, when the abscess which has formed either breaks, or is opened 
by the physician. When it assumes a chronic form, the child is 
more or less deaf, from the obstruction of the inner ear by the 
enlarged tonsil ; the child has a certain peculiar tone of voice, and 
the tonsils are seen to be greatly swollen. This state is increased 
on the occasion of damp weather. 

How Treated. A cooling aperient should be given, to promote 
the action of the bowels, and aid in reducing the fever. Sooth- 



2 88 Diseases of Children. 

ing drinks, as flaxseed or slippery elm tea, may be used with wine 
oApecac, say twenty to thirty drops, every four or five hours, ac- 
cording to the urgency of the symptoms. Gargling with chlorate 
of potassa, and tincture of the chloride of iron (teaspoonful to a 
pint of water), will generally be found of service (see p. 347 for 
gargles). When the pain and swelling are great, leeches may be 
applied to the throat, or poultices of Indian meal mush, flaxseed, 
etc., may be employed. Some prefer the free use, to the outside 
of the throat, of hartshorn liniment, tincture of iodine, or even a 
blister. But if, from the throbbing, swelling, and pain, there can 
be no doubt of the formation of an abscess, poultices, as given, 
page 358, should be freely employed, until the abscess breaks, or is 
opened. In performing this operation, care is required to avoid 
severe, even fatal bleeding, which might occur if a large vessel 
were cut. 

When swelling of the tonsils becomes chronic, gargles of an 
astringent character may be used, as alum, teaspoonful to half a 
pint, tincture of iron, the same quantity, etc., or touching them 
each day with the nitrate of silver will cause them to contract. 
This failing, the excess must be removed by the use of a cutting 
instrument. 

Croup. This scourge of childhood is divided into two varieties, 
true croup, or pseudo-membranous, and false, or spasm of the larynx. 
True or membranous croup is regarded by some as identical with 
diphtheria, inasmuch as both are characterized by the formation of 
a false membrane in the throat. A discussion of this point would 
be foreign to the purpose of the present work, though it may be 
mentioned that in croup the membrane is formed on the surface, 
while that in diphtheria dips down, as it were, and forms beneath 
the surface of the mucous lining of the throat. 

How Distinguished. In membranous or true croup, the child is 
attacked during the night, often without any previous symptoms, or, 
perhaps, a slight hoarseness and cough before retiring, by a sharp, 
shrill cough, which sounds exactly like the bark of a small dog. 
There is a sense of suffocation, hurried breathing; every movement 
shows the earnest desire for breath, and the fear of strangling. 
Generally, the cough is in distinctive paroxysms, and relief occurs 



Croup. 289 

toward morning, or is the result of the remedies employed. 
Should, however, the disease continue, the inflammation goes on, 
the fever is greater, the voice is hoarse, the sense of suffocation be- 
comes intense, the cough is constant, the child grasps at its throat 
as though to tear something away, the breathing is panting, and 
the tongue is thickly furred. The attacks occur at night, with an 
abatement of the symptoms in the morning; there is no expectora- 
tion ; talking increases the pain, and the thirst is constant. This 
goes on, with shortening of the intervals ; the cough becomes fee- 
ble ; the voice is lost ; drowsiness comes on, and the child sleeps 
and starts in terror, grasping wildly at those around, as if for relief. 
In fifteen or twenty hours, unless relief is obtained, coma or stupor 
comes on, and the child dies exhausted. 

Sow Treated. No ailment requires such prompt, unremitting 
attention as this. Early medication, even where the disease is only 
apprehended, will often prevent further progress, and ward off dan- 
gerous results. A catarrh, with a suspicious ringing, barking 
cough, should be carefully watched. A warm bath for a quarter 
of an hour will relieve the spasmodic inflammatory tendency ; then 
the little patient should be kept in a room, preferably in bed, with 
an atmosphere kept moist by the vapor of boiling water, and the 
full emetic effect produced by the administration of powdered 
alum. A teaspoonful may be mixed with double as much honey, 
and given at once (p. 345). Some regard this article as having a 
specific effect in relieving croup. Others prefer ipecac, as the 
syrup or wine, or mustard water. The warm bath may be repeated, 
if necessary, in a few hours, and the fever and inflammatory symp- 
toms kept down by salines, with ipecacuanha, or tartar emetic. 
Should these fail, and inflammation fully set in, the most active 
exertions will be required. "Wine of ipecacuanha may be given, 
say one to two drachms, according to age, every ten or fifteen min- 
utes, until free vomiting results, and then its effects kept up until 
complete relief is obtained. Then it may be followed by the solu- 
tion of acetate of potassa, with ipecacuanha. Alum is preferable, 
as less exhausting; and if debility is coming on, senega tea (p. 
349), containing in each dose five grains of carbonate of ammonia, 
may be employed. When the advance still continues, the throat 
25 



2 go Diseases of Children. 

must be painted with tincture of iodine, being careful not to allow 
it to cause a blister, while the powers are sustained with beef tea, 
milk punch, wine whey, etc. 

A variety of other remedies have been found of use, as muriate 
ofammonia,threeor four grains, andthegargle of lime-water given (p. 
347). Other local remedies are the tincture of chloride of iron, 
with glycerine; or carbolic acid and glycerine. 

Very excellent results have often been secured by causing the 
child to inhale the vapor of slaking lime, on the principle that it 
acts to soften and loosen the membrane. This may be employed, 
with care, at any period of the disease. Water should be poured on 
a piece of quick-lime the size of an orange, and the child held so as 
to breathe freely the vapors arising from it. 

Tracheotomy, or opening the windpipe to permit the entrance of 
air rarely succeeds, perhaps because it is rarely performed until too 
late to be of service. It is, moreover, an operation none but a 
skilled surgeon can perform, so we need not discuss it. 

Spasviodic Croup, Spurious or False Croup, never has any false 
membrane or inflammation to occur. It is very mild, comparatively 
speaking, and yet resembles true croup in many particulars. 

How Distinguished. The attack commences with a slight cold, 
followed at night by difficulty of breathing, slight fever, and the 
singular barking cough. All the symptoms of inflammation are 
absent, though there may be increased heat, great hoarseness, thirst, 
and a peculiar crowing respiration. Occasionally, these symptoms 
result in convulsions, or congestion of the brain. Or there may be 
alon- with it spasms of the extremities, clenching of the hands, etc 
How Treated. The emetic effects of powdered alum, given as 
recommended for true croup, are of especial value. Turpentine 
liniment or stupes may be applied to the throat (see page 346), or 
poultices of various kinds. Ipecacuanha, teaspoonful doses of the 
syrup, until vomiting is produced, is of great avail. The strength 
must be carefully kept up by nourishing food, and stimulants^ if 
necessar/, and after the subsidence of the attack iron and quinine 

will be useful. 

Diphtheria. The treatment of this disease, and, in fact, every- 
thing relative to it, have been very carefully given on a previous 



Whooping Cough. 291 

page. When the disease occurs in children, the symptoms are 
identical, though not so easily recognized. Many regard it as the same 
with membranous croup, though there is yet room to believe that 
diphtheria is the result of a special poison, with a tendency to the 
throat. 

How Distinguished. Diphtheria is ushered in by symptoms of sore 
throat, high fever, marked debility, soon followed by acute soreness 
of the whole of the throat, which is of a deep red or livid color, and 
covered with a coating like dirty chamois leather. This may extend 
all over the inside of the mouth, down the throat, into the nostrils, 
etc. When it extends into the larynx there is a cough like croup, 
harsh breathing, like a hissing or whistling. In very many cases, 
death results from exhaustion, or stupor, the effects of the poison 
upon the system. 

How Treated. If seen early, the free use of the chlorate of 
potassa gargle (p. 347), generally relieves the attack and prevents 
the extension of the disease. Combined with this, the tincture of 
the chloride of iron is of great benefit. Quinine, good nourishment, 
stimulation, all must be employed to aid in the treatment. 

Grargles or swabbings with solutions of tincture of iron, carbolic 
acid, permanganate of potassa, and of lime-water (p. 347), may be 
used from time to time, though care should be taken lest, by rough- 
ness to the diseased parts, injury be done and bad results follow. 

Whooping Cough, or "Pertussis," is rarely seen except in 
children. It is caused wholly by contagion, and generally occurs 
but once. 

How Distinguished. The premonitory symptoms are those of 
bronchitis, which is followed by a cough returning in spasms. In 
the intervals, the child exhibits but little appearance of anything 
untoward, when suddenly a paroxysm occurs, which lasts even for 
several minutes. The whoop is so peculiar that it is quite easy of 
recognition. The cough commences and continues as a series of 
short, violent efforts to relieve the throat, and at times results in 
bleeding at the nose, eyes and mouth. The face becomes suffused, 
the eyes are injected, the head aches, and the child ceases, and 
falls back exhausted. All cases do not have the peculiar whoop. 
The matter brought up is thick, ropy; sometimes mixed with blood 



292 Diseases of Children. 

and pus. Or the efforts may bring on vomiting, when the food 
recently taken will be mingled with the expectoration. 

The duration is about six or eight weeks, rarely less, often much 
longer, even for months. 

It may be complicated with congestion of the brain, of the lungs, 
deafness, pneumonia, and convulsions. 

How Treated. Care and avoidance of exposure to cold and 
dampness are required, even in the mildest cases, to avoid the 
setting in of other allied diseases. But it is not advantageous to 
keep the patient constantly in the house. The next point is to 
moderate, if possible, the force and frequency of the paroxysms. 
If the cough is tight, expectoration may be aided by squills, ipe- 
cacuanha, or other similar remedies. (See Nos. 144, 145, 155, 
pp. 349, 350.) Fever, when present, is relieved by the solution of 
acetate of ammonia. For the moderation of the spasms, an almost 
endless variety of remedies have been tried. Of these the best 
are the bromide of ammonium, coffee, tea of chestnut leaves, or of 
clover, hay tea, cinchona tea, and chloral. 

Almost any one of these articles will modify the attack, often 
will shoi-ten it. Quinine in small doses, or chloral in the same 
way, have been highly lauded. Inhalations, as of the common 
illuminating gas well diluted, steam from boiling water, or the same 
containing tar, cubebs, and carbolic acid, have been found of service 
(see page 351). Perhaps the best plan to relieve the force of a 
paroxysm, when prolonged, is the inhalation of chloroform, one or 
two drops at a time. The general health should be regarded, and 
tonics, especially iron, cinchona tea, or quinine, should be em- 
ployed when required. 

Strangulation has been known to occur by a sudden commence- 
ment of a paroxysm during eating. Therefore, children thus 
suffering should be watched at their meals, and be required to have 
their food cut fine previous to placing it in the mouth. 

As an efficient formula in this disease, we give the following: — 

WHOOPING COUGH MIXTURE. 

Take Bromide of Potash, two drachms 

Tincture of Belladonna, two drachms 

Syrup of Wild Cherry Bark, three ounces. 

Mix, and give a teaspoon ful every two or four hours, as required. 



Bronchitis. 293 

Coughs and Colds, in children, are constantly occurring as the 
result of exposure to cold and dampness, and the neglect to which 
so many are subjected. 

These should never be neglected, but at the outset should be 
subjected to appropriate treatment. Early care might thus prevent 
a dangerous catarrh, pneumonia, croup, etc. Proper clothing, 
protecting the arms to the wrist, and the feet and legs, and parti* 
cularly the chest, will act as a preventive of many of these affections, 
which, while not fatal in childhood, may lay the foundation of 
serious diseases in after-life. A mild expectorant, with proper 
tonic treatment, will often speedily relieve these incipient symptoms. 

Bronchitis is known by its commencing as a common catarrh, 
which rapidly becomes aggravated, with light fever, hurried respi- 
ration, quick pulse, light dry cough, hoarseness. As it increases, 
the breathing is labored and wheezing, the cough is painful, with 
more or less rattling in the chest, the appearance is languid, and 
debility rapidly ensues. Choking up of the smaller tubes with the 
free mucous discharge may occur, and lead to a collapse of that part 
of the lungs. Or the smaller tubes may be attacked by the bron- 
chitis ; the inflammation is then very high, and pus is soon formed, 
and death is almost sure to follow. 

How Treated. Slight cases will only need care, a warm atmos- 
phere, good, nourishing diet, and soothing drinks. If necessary, a 
saline mixture may be given, to act on the bowels, as No. 101, p. 
341. When the case is severe, with high fever, some emetic, as 
mustard or syrup of ipecacuanha, will be needed, warm baths, and 
the promotion of free perspiration by warm drinks. The carbon- 
ate of ammonia, in three-grain doses, will prove of value, combined 
with senega, to promote free secretion. The following prescription 
is a useful one : — 

COUGH MIXTURE. 

Take Carbonate of Ammonia, one drachm 

Syrup of Senega, half an ounce 

Paregoric, half an ounce 

Balsam of Tolu, one ounce. 

Half a teaspoonful, three or four times a day, to a child ten years old. 

A good treatment for an ordinary "hard cold" in children is, 

25* 




294 Diseases of Children. 

as soon as it commences, to give the child a warm "hip-bath," in 
Fig. 101. salt water, or mustard water. For this pur- 

pose, the form of tub exhibited in Fig. lUl is 
most useful. 

The hip-bath also furnishes a very conve- 
nient and powerful means of acting upon the 
lower part of the spinal marrow and the pelvic 
organs. It may be very well taken in the ves- 
sel of which the annexed drawing illustrates 
for the form ; it has the important advantage of 
children. we n supporting the back, while the patient is 

in the sitting posture. 

"When there is a large family, such a one comes frequently into 
use. Alter the bath, which should last ten minutes, the child 
should be well dried, and put to bed between blankets, and given 
freely to drink of a solution of acetate of potassa, a teaspoonful to a 
wineglassful of water, or else " cream of tartar water," made by 
pouring a pint of boiling water on an ounce of cream of tartar. 
Either may be sweetened to the taste. The next day the child may 
take half a teaspoonful of syrup of ipecac every three or four hours. 
This will generally break a cold in two or three days. 

"When the first symptoms arc over, and a cough remains, one of 
the prescriptions, Nos. 144, 145, or 155, may be given; the last 
mentioned, well sweetened, is especially appropriate for children. 

"When the symptoms subside, tonics, good diet, and stimulants 
should be administered. 

In all such cases, remedies containing much opium, or any of its 
preparations, must be used with caution. Many persons think if 
they quiet the cough the disease is cured, but they often thus, as 
it were, merely check the expression of the trouble which is endan- 
gering the child. The dose should always be small, and the result 
carefully watched. 

Pneumonia, Lung Fever, or Inflammation of the Lungs, is 
another result of cold and exposure. Fortunately, it is not of very 
frequent occurrence in children, since it is a very fatal one. 

How Distinguished. The disease commences rather suddenly, 
often in the night, with chills, cough, quick breathing, great heat 



Colic. 295 

of the skin, rapid pulse, tliirsfc, and general fever. Sometimes, it 
may even commence with a convulsion. As children almost always 
swallow the spittle, the characteristic sign of rust-colored saliva is 
lost. As the symptoms so much resemble those of acute bronchitis, 
the distinction is made out by the greater severity of the symptoms, 
the intense heat of the chest, the quick, feeble pulse, the panting 
breathing, and the lung sounds on placing the ear to the chest. A 
marked symptom is the wide expansion of the nostrils, and their 
rapid movement. 

How Treated. The bowels should be kept open by mild purga- 
tives. Expectoration may be aided by emetics, as recommended 
above, and the fever checked by the solution of the acetate of am- 
monia. The diet should at first be light. The chest may be 
occasionally irritated by mustard plasters, or the application of tur- 
pentine in stupes or fomentations (p. 346). Blisters are rarely 
beneficial, and are best omitted. To relieve restlessness, bromide 
of potassium, in five-grain doses, and the warm bath, will prove of 
service. If debility come on, beef tea, wine whey, and stimulants 
are necessary, though this tendency must always be borne in mind, 
and the strength carefully guarded throughout. 

Iron, and cinchona preparations are requisite to aid the conva- 
lescence. The cough which is often left behind must be managed 
as above directed under that heading. 

Colic, or Gripes, in children, is a disease of constant occurrence. 
It is also regarded as a neuralgia of the bowel. 

How Brought On. This affection is the result of indigestion, as 
brought on by improper food, overloaded stomach, etc., or it seems 
to have an intermittent tendency, recurring at a certain hour, gene- 
rally late in the afternoon, day after day. Or it may be brought 
on by cold and dampness to the feet. Often, carelessness, and want 
of proper changing of a wet diaper, will cause such an attack. 

How Distinguished. Generally, there is more or less wind in 
the bowels, as shown by the distention of the abdomen, and the 
drum sound on percussion. Again, very little wind may be pres- 
ent. The child becomes fretful, draws its knees up to its chest, 
cries suddenly, and becomes quiet. These actions may be repeated 
at intervals, often very short, sometimes of greater duration, but 



296 Diseases of Childre?i. 

rarely disappear until wind has passed from the bowels, or perhaps 
a thin and frothy discharge occurs. All these symptoms may be 
exaggerated, the screams are piercing, the contractions of the lirubs 
are almost spasmodic, the face exhibits great suffering, the child is 
bathed in perspiration, and yet, when the attack passes off, the child 
appears as well as usual. These attacks are often observed in the 
cases of children otherwise remarkably healthy. 

In rare cases, the attack becomes convulsive, almost epileptic, 
though the intervals are marked by apparent health. 

How Treated. The paroxysms are so distressing that the earnest 
desire is to give the child immediate relief. This wish is met by 
the warm bath, hot fomentations to the abdomen, particularly flan- 
nel wrung out of hot mustard water (p. 347); poultices of hops; 
mustard plasters, not too long continued; spice poultices, etc. At 
the same time may be given by the mouth, camphor in water, as 
No. 193, p. 357, or oil of turpentine dropped on sugar, say three 
to five drops every two or three hours. A favorite and highly 
useful mixture is chloroform, one drop, syrup of gum arabic, and 
mint water or anise water, of each half a teaspoonful, repeated 
every fifteen minutes, until complete relief is obtained. The bowels 
should be well opened by stimulating enemas, as of castor oil with 
a few drops of turpentine, or that given, No. 102, p. 341, repeated 
as necessary. A few drops of laudanum, or a half teaspoonful of 
paregoric, may be considered as safe and useful. Other remedies, 
as bromide of potassium, and chloral, may be employed, both by 
the mouth and by enemas, as necessity may require. In all cases, 
constipation must be relieved, and acidity corrected, by the appro- 
priate remedies, as heretofore mentioned. In some cases, mustard 
plasters to the whole length of the spine, or stimulating frictions 
over it and the stomach, prove of great service. 

How Prevented. By avoiding constipation, and the consequent 
accumulation of wind in the bowels, much may be done to prevent 
attacks of colic. Thus, occasional enemas of molasses, salt and 
milk, or the administration of magnesia, with belladonna, or hyoscya- 
mus and ipecacuanha, will generally keep the bowels in a relaxed 
condition. Then the feet should always be kept dry and warm, and 
the linen changed when wet, lest its coldness induce an attack. 



Slimmer Complaint. 297 

Summer Complaint, and Cholera Infantum, are almost wholly 
confined to the hottest parts of the summer months. By some, 
these are regarded as names of the same disease. By others, the 
former is considered as the ordinary diarrhoea of children, occurring 
during the entire summer. 

How Brought On. Diarrhoea, in children, is the result of indi- 
gestion, eating improper food, as unripe fruit, or fruit partly decayed, 
difficult teething, exposure to cold and dampness, especially wet 
feet. Still, at certain times, the disease prevails much more exten- 
sively, appearing to attack almost every infant in certain localities. 

Cholera Infantum almost never has been met with beyond the 
limits of the United States, and generally prevails extensively, dur- 
ing the hottest months, all over the country, but particularly in large 
cities, though by no means being confined to the poorest and filthiest 
localities, but as often attacking children placed under the best provi- 
sions for light, air, cleanliness, etc. This disease rarely attacks child- 
ren above two years of age, mostly during the first teething, and for 
this reason the second summer is always regarded with fear and 
anxiety. It is one of the most fatal diseases of childhood. Any 
cause impairing the vitality, as general constitutional disorder, depri- 
vation of the breast, etc., is sure to induce an attack. For this 
reason, weaning is often postponed until after the second summer. 
Yet, in many instances, when the breast milk is becoming impover- 
ished, and unsuitable for the child, it would be far better to wean 
the child, and commence a proper diet with it some weeks previous 
to the setting in of hot weather, rather than attempt to carry it 
through the heated term on nourishment manifestly improper. 
These remarks would apply where pregnancy has again commenced ; 
where the teeth are well out, and the child is prepared for other 
food ; where, for any cause, the breast milk is impoverished, or its 
supply insufficient. 

Again, when the child is so situated as to rely wholly upon cow's 
milk, or other artificial feeding, the milk furnished should be care- 
fully examined, to be sure that it is pure, fresh, and not weakened 
by water or other adulteration. 

How Distinguished. Summer complaint and cholera infantum 
will be considered as synonymous terms, as the same principles for 



298 Diseases of Children. 

the treatment of the ordinary diarrhoea of childhood will apply in 
every instance, guided by that common sense which is so eminently 
necessary for the treatment of all disease. 

In some cases the attack is quite sudden ; the child is seized 
with vomiting, purging, slight fever, great desire for drinks, rest- 
lessness; the stomach and bowels being emptied, the discharges 
become watery, whitish, ill-smelling, or even odorless. The stomach 
is very irritable, rejecting suddenly and forcibly everything that is 
taken into it. The progress is rapid; in a few days, or even a few 
hours, the child comes to resemble a wilted, aged person. The 
pulse is quick, small, like a thread under the finger ; the tongue is white 
and slimy ; the skin is dry, dirty-looking and harsh ; the feet and hands 
are apt to be cold. Generally, the feverish symptoms increase late in 
the afternoon. The child may express great suffering, as if in 
pain, or may lie prostrate and uncomplaining ; generally, there is great 
restlessness, with drawing up of the knees and moaning ; constant 
tossing and changing of the position, and often sharp, shrill screams. 
The abdomen is more or less swollen, and tender to the touch. 
Frequently, the vomiting ceases early, though the diarrhoea con- 
tinues, or increases in violence; everything seems to pass through 
the bowels without any effort at digestion, in a very short time 
after it is taken. Delirium or other symptoms simulating cerebral 
affection come on, and the attendants, even the physician, are led to 
believe that the brain is inflamed, though these symptoms are solely 
' the result of the great exhaustion, and deprivation of the brain of 
its proper supply of blood. 

Very many cases succumb within twenty-four hours, though the 
majority are slower in reaching a fatal termination. Here, the 
emaciation is extreme, the eyes sink in, the whole face is pale, the 
nose is sharp, the lips are thin and dry, the skin is drawn over the 
cheek bones and forehead so tightly as to be smooth and glistening. 
The child is but half conscious, lies with the eyes partially closed, 
and permits the dust and even insects to settle on its eye-balls 
without noticing them. Every symptom betokens the approach of 
death, which, singularly, is often long in coming, giving hope of a 
recovery, long after the child is really in the agonies of death. The 



Summer Complaint. 299 

child generally dies in an unconscious state ; occasionally it is attacked 
with convulsions. 

Favorable symptoms are, a decided change in the character and 
frequency of the passages, desire for food, quiet slumber, reduction 
of the pulse, moisture of the skin. 

How Treated. The first and most important measure is the 
removal of the child to a cooler atmosphere, of the sea-shore, best 
of all ; the pure country air ; or taking it out early in the morning, 
beyond the built-up portions of the city, where it can breathe a 
purer air. Excursions on the water, as in the ferry-boats of our 
large cities, will aid greatly in inducing a favorable change. Under 
any circumstances, the air of the apartment occupied by the child 
must be completely purified by free ventilation, the most positive 
cleanliness, the avoidance of many persons in the room. The air 
of the room must be kept dry, and free from anything that will 
vitiate it, as cooking, tobacco smoke, etc. The clothing must be 
light, clean, and dry, and sufficient to protect the child from 
atmospheric changes, but not to keep it too warm. The bed 
should be cool, hence feathers should be avoided ; a mattress, or a 
blanket only, thick enough to make the couch comfortable. 

When there is reason to suspect teething as a cause, the gums 
should be cut, if necessary, as will hereafter be described, and if 
they are hot, swollen, and tender, rubbing them with a piece of ice 
will greatly relieve their irritability. The whole surface of the 
body should be bathed night and morning with tepid salt water, and 
then the skin should be excited to action by frictions with a soft 
towel or the hand. The diet should be restricted to the breast-milk, 
or, in older children, to pure cow's milk, properly prepared, not too 
much diluted; "condensed milk" is highly esteemed by many as 
the very best food for these cases. Overloading of the stomach 
must be very carefully guarded against. Cold demulcent drinks 
or ice may be allowed. 

The diarrhoea in its beginning may often be speedily checked by 
a slight astringent, as acetate of lead, one-fourth to one-half a grain, 
and three or four grains of prepared chalk every two, three, or four 
hours, according to the urgency of the symptoms. The irritability 
of the stomach can often be relieved by a few grains of magnesia, 



300 Diseases of Children. 

rubbed up with white sugar, and placed upon the tongue; or by 
three or four drops of dilute sulphuric acid in syrup and spearmint 
water every hour. Other remedies for the vomiting are camphor 
one fluidounce to ether one fluiddrachm, given in doses of two or 
three drops at short intervals ; or a few drops of turpentine, or 
creasote, in a solution of acetate of lead, say, acetate of lead five 
grains, dilute acetic acid three to five drops, sugar two to three 
teaspoonfuls, and water one ounce, given in teaspoonful doses every 
hour till relieved. When all else fails, a blister may be placed 
over the stomach, followed by a poultice of bread and milk, or of 
flaxseed, etc. When there is great pain of the bowels, leeches may 
be applied, and followed by hop or other soothing poultices. 

Should brain symptoms appear, leeches may be applied behind 
the ears, to the temples, cold lotions or the ice-bag to the whole of 
the scalp, stimulants to the lower extremities. 

One of the most valuable remedial agents is the application of 
stimulating liniments to the whole length of the spine, and the 
abdomen. This is done in the belief that the counter-irritatiun 
will act to draw away the irritation from the stomach and bowels. 
Such liniments are mentioned, Nob. 164, 166, and 171 (p. 353). 

When the symptoms begin to improve, the diarrhcea may be 
checked by a continuance of the acetate of lead, etc., combined with 
small doses of ipecacuanha; or the vegetable astringents, as men- 
tioned on pages 348, 349. 

Should the disease tend to become chronic, perhaps the best 
remedy will be the tincture of the chloride of iron given in syrup 
and water, in doses of three to five drops every two, three, or four 
hours, according to age. Laudanum or paregoric, in appropriate 
doses, may be used cautiously, if required by pain. A decoction 
of blackberry root (p. 349) has been found of especial service. 
What is commonly known as "thickened milk," milk boiled and 
thickened with flour, or rice flour, enjoys a high reputation in these 



Quinine in small and frequent doses will act as an efficient tonic. 
The aromatic spirits of ammonia, in doses of ten to fifteen drops, in 
syrup and water, often proves an excellent stimulant, and quiets the 
irritability of the system. 



Falling of the Bowel. 301 

In closing this important subject, we append the following list 
of things to be done when a child is suddenly attacked, in summer, 
with vomiting, purging, and prostration : — 

1. Put the child for a few minutes in a hot bath, then carefully 
wipe it dry with a warm towel, and wrap it in warm blankets. If 
its hands and feet are cold, fill bottles with hot water, wrap them in 
flannel, and lay against them. 

2. Place over the belly a mush poultice, or one made of flaxseed 
meal, to which one-quarter part of mustard flour has been added, 
or flannels wrung out of hot vinegar and water. 

3. Give five drops of brandy in a teaspoonful of water every 
ten or fifteen minutes ; if the vomiting persists, give this brandy in 
the same quantity of milk and lime-water. 

4. If the diarrhoea has just begun, give a teaspoonful of castor- 
oil, or of the spiced syrup of rhubarb. 

5. If the child has been fed partly on the breast and partly on 
other food, the mother's milk alone must now be used. If the 
child has been weaned, it should have its milk-food diluted 
with lime-water, or should have weak beef tea, or chicken water. 

6. Give the child cold water to drink, freely. 

7. Have the soiled diapers or the discharges at once removed 
from the room. 

Falling of the Bowel, or Prolapse of the Anus, is generally 
observed in debilitated children, or after protracted diarrhoea. On 
the other hand, it may come on from constipation and the constant 
straining to extrude the hardened stools. In some, it occurs after 
every passage, or even if the child stands for a long time. 

How Distinguished. The child is observed to suffer greatly, and 
examination reveals the presence of a red tumor at the opening, 
which is generally easily pushed back. If allowed to remain" down 
long, it becomes strangulated, and gorged with blood, inflames, and 
may even ulcerate or become mortified. 

How Treated. The reduction should be performed at once, by 
anointing the parts with sweet oil, lard, etc., and then gently press- 
ing it back, and being sure to see that it is completely returned, 
and no portion allowed to remain grasped by the sphincter or lower 
muscle controlling the opening of the bowel. If it is constantly 
26 



302 Diseases of Children. 

recurring, an injection may be thrown into the bowel, consisting of 
bismuth and catechu, No. 103 (p. 341). In cases where the 
part is much engorged and difficult to return, the free use of cold 
water to the part will relieve it, or a few leeches may be applied 
before any effort is made to return it. The parts may then be 
washed frequently >rith astringent lotions, as strong alum water ; 
a decoction of white oak bark ; or the two may be combined ; or a 
decoction of galls may be used. 

The accident must be prevented by keeping the bowels relaxed 
by proper food, fruit, etc., and by careful attention at the time of 
having an operation of the bowels. In severe cases, it becomes 
necessary to retain the bowel in place by a pad or compress, held on 
by a bandage. It is proposed to reduce the size of the opening, 
and thus retain the bowel, by removing a portion of the projecting 
folds. This has proved successful in some cases, but of course 
requires the hand of a competent surgeon. 

Polypus of the Rectum is often mistaken for falling of the 
bowel, which it may closely resemble. It is not of common occur- 
rence. 

How Distinguished. A polypus may exist in the lower bowel 
for some time before its presence is recognized. It is generally 
marked by tenesmus at each evacuation, mucous or bloody dis- 
charges, and as it becomes larger, it acts as a foreign body, and 
annoys the child greatly. Finally, after one of these efforts, it is 
extruded, and shows like a lump or tumor of a dark red color, some- 
times of a dirty yellowish appearance, and often covered with mu- 
cus, more or less bloody. 

The red form generally bleeds freely from slight causes. 

It is known not to be a falling of the bowel, because it is in the 
centre, and the finger can be passed all around it, and up to its root. 
In some cases, it does not protrude, and is only detected by an 
examination for the cause of the difficulty experienced by the child. 
Often, it drains away the blood and causes great prostration, etc. 

How Treated. The only proper treatment is removal, if small, 
by twisting the polypus off by means of a pair of forceps ; if large, 
by strangling it with a ligature, and thus cutting off the entire 
tumor. The lump is pulled down with a pair of forceps, and then 



Weaning Brash. 303 

# • 
a waxed ligature is placed around the stem or root, and drawn 

tight. If troublesome bleeding follows, the sulphate of iron, freely 

applied to the point, will readily control it. 

Bed-Wetting, or Incontinence of Urine, is a most annoying 
affection of children, and, singularly, is most frequent in colored 
children. This is often the result of habit ; want of proper teach- 
ing; a lack of mental capacity; or it may result from a partial 
paralysis of the retaining muscle of the bladder. It most com- 
monly occurs at night, while in bed, and hence its name. Espe- 
cially is this likely to occur when care is not taken to have the 
child pass its water before going to bed. It may be the result of 
the urine containing irritating salts, and thus causing the child so 
much distress that it half consciously allows the urine to escape. 
In these instances, the child is observed to use the vessel very fre- 
quently during the waking hours. Some assert that the discharge 
of the water only occurs when the child turns on its back, and 
hence propose and insist on the good results of a blister to the 
back, to prevent the child from assuming that position. 

How Treated. When the urine is being constantly passed, its 
irritating nature may be corrected by daily exercise in the air; 
avoiding exposure to cold and damp ; alkalies, as lime water and 
bicarbonate of soda, five grains thrice daily, with mild, bitter 
tonics, as cinchona tea (p. 349), keeping the bowels free, improv- 
ing the digestion, etc. Often, under this plan, the trouble will 
quickly disappear, and recovery be permanent. 

In all cases, the child should have a light supper; be allowed to 
drink but little of fluids toward night, and empty his bladder the 
last act before retiring. As a medicine, the tincture of cantharides, 
say three to five or ten drops, three times a day, gradually increas- 
ing the dose, will eventually relieve the difficulty. Care should be 
taken to stop this remedy at once if painful and difficult urination 
is complained of. Belladonna, in repeated doses long continued, 
has acquired a great reputation. Two to five drops of the tincture 
of belladonna should be given in sweetened water every night. 

Weaning Brash, or diarrhoea, or looseness of the bowels at 
the time of weaning, most frequently occurs during the summer, 
and is often the result of negligence as to the food. The utmost 



304 Diseases of Children. 

care is necessary to see that the milk given the child is pure, fresh, 
and not too much, if at all, diluted. Generally, the diarrhoea is 
checked by these attentions, and the use of prepared chalk, and 
calomel, followed by a mild astringent. When protracted, the same 
principles will apply as given under similar headings heretofore. 

Galling, or Rubbing, is most generally seen in fat children, and 
those of a scrofulous or flabby predisposition. Such cases require 
care as to cleanliness, and the avoidance of much friction, or soap 
and water in removing any soiling that may occur. Hence some 
mothers are said to be too cleanly, and clean the skin off their 
children. The parts should be dried by swabbing or patting with 
a soft cloth, in place of rubbing with a rough, coarse towel. After 
which, they should be dusted with fine starch, prepared chalk, 
oxide of zinc, lycopodium, etc. An excellent application is the 
oxide of zinc ointment, page 356, with care to prevent the parts 
from coming into contact. Some children are greatly relieved by 
bathing the parts with tepid water frequently, or with slippery elm 
or flaxseed mucilage. 

Milk Crust generally occurs during teething, and while the child is 
yet nursing, hence its name ; and it is commonly thought to be incur- 
able until all the teeth are cut or weaning takes place. It usually 
appears in children of scrofulous tendency, and is, by its disgusting 
appearance, a great source of annoyance. 

How Distinguished. Milk crust is an eruption, upon the face 
or head, of a number of red blotches, soon covered with pustules ; 
these, itching and breaking, exude a whitish-yellow or greenish 
discharge, which hardens and forms a thick brown crust, beneath 
which the discharge continues to ooze, and constantly adds to the 
crusts. These crusts may appear only on the cheeks or chin, over a 
small space, or they may cover the whole scalp and face, forming a 
mask of hideous appearance. In the course of three or four weeks 
the discharge ceases, the crusts fall off, leaving a red, shining sur- 
face, very irritable, and liable to renew the pustules and discharge 
as before. This matter seems to act as a source of conveyance of 
the disease, as, wherever it is brought in contact with the skin, it 
produces more or less of a similar irritation. Fortunately, the 
disease leaves no scar or marks after healing. 



Milk Crust. 305 

How Treated. In the early stages, it will often speedily yield 
to proper regulation of the diet, mild laxatives, and soothing lotions. 
Small doses of magnesia and ipecacuanha, warm baths, pure, fresh 
air, are invaluable adjuncts in the treatment. Occasionally, it 
becomes necessary to add tonics, as potassio-tartrate, or syrup of the 
iodide of iron (p. 361), infusions of cinchona, dogwood, goose grass, 
etc. (p. 349). As local applications to kill the itching and cause the 
eruption to disappear, the ointment of nitrate of mercury, say one 
part to three of clean lard; or oxide of zinc ointment (p. 356); 
or camphor and chloral, equal parts, rubbed up till tbey melt, and 
added to glycerine or simple cerate, in the proportion of half a 
drachm to the ounce, or stronger, as may be required. 

In very greatly protracted cases, the solution of the arseniate of 
potassa, or "Fowler's solution," in two-drop doses three times a day, 
will generally effect a cure, if persisted in. 




26* 



CHAPTER IX. 

Accidents, Injuries, and Surgical Ailments op 
Children. 



Lancing the Gums — Tongue Tie — Hare Lip — Wry Neck — Sore Eyes — 
Cross Eyes — Ingrowing Eyelashes — Styes — Running, or Catarrh of the 
Ears — Earache — Crushed Fingers — Hip Disease — SpinaPDiseases: Cur- 
vature of the Spine, Inflammation of the Spine, Dropsy of the Spine — 
CJub Foot — Weak Ankles — Knock-Knee — Rupture, or Hernia — Cancer 
— Swellings of the Glands of the Neck. 

Of course, children are exposed to many of the same accidents 
to which adults are liable, and the treatment is generally the same. 
What it is, has already been described in Chapter VII. But child- 
ren are also particularly subject to certain injuries and surgical 
diseases to which parents should be prepared to give early and 
intelligent attention. Frequently, years of misery or permanent 
disfigurement can be avoided by correcting a bad habit in a child, 
or by giving some apparently trifling symptom prompt care. There- 
fore the present chapter should be read by every parent with close 
study. 

Lancing the Gums. The first teeth commence to appear sev- 
eral months after birth, and are usually accompanied by a flow of 
saliva ; redness and swelling of the gums ; heat and tenderness of 
the inside of the mouth; sometimes, general fever; more or less 
diarrhoea, and even fits or convulsions, as we have described more 
at length on a previous page. When these symptoms commence to 
threaten the general health of the child, the proper step is to lance 
the gums with a gum lancet. 

To perform this operation, an assistant should hold the child 
firmly on his lap, fixing its head so that it cannot move it. The 
306 



Wry Neck. 



307 




operator then depresses the lower jaw with his left hand, holding 

in his right a gum lancet, or, if that is Fig. 102. 

not at hand, a sharp penknife, the blade 

of which is wrapped in linen in such 

a way that the point is only uncovered 

for rather less than half an inch. At 

first, one cut should be made lengthways 

of the gum, and then a second one 

across it at right angles. 

Figure 102 indicates the method of 
holding the child's mouth and making 
the first incision. When, as rarely Lancing a Child's Gums 
happens, there is excessive bleeding after the operation, the gums 
may be bathed with alum water, or powdered galls may be sprin- 
kled upon them. 

Tongue Tie. This is brought about by the tongue being fast- 
ened to the floor of the mouth by what is called the "frsenum," 
which is the thin membrane seen running beneath the tongue when 
we elevate it. In tongue tie this extends nearly, or quite, to the 
tip of the tongue, and fastens it down. The deformity can easily 
be remedied by nipping a very small notch, with the scissors, in the 
middle of the free edge of the frasnurn, and then, for several days 
after the operation, passing the little finger beneath the tongue two 
or three times, so as to tear the cut a little larger and prevent its 
edges uniting. 

Hare Lip. The distressing deformity so called receives its name 
because the child's upper lip is divided by a cleft, as it is in the hare 
or rabbit. There are many opinions as to its cause, which need not 
detain us now. The only remedy for it is a surgical operation, and 
why we mention it here is to urge upon parents to have this per- 
formed within the first few months, or, at least, in the first year 
of life. Too many delay, out of timidity, and thus, when the ope- 
ration is submitted to, a scar is sure to be left, which could be 
avoided by an earlier recourse to the knife. 

Wry Neck sometimes arises from feeble muscular power on one 
side of the body. The child's head is drawn to the stronger side 
by the greater contractile power of the muscles, and after a time 



308 Diseases of Children. 

he actually loses the ability to keep it in an erect position. As 
soon as the least tendency to this is noticed, the child should be 
encouraged to resist it; his general health should be strengthened 
by tonics, as quinine or iron ; nourishing food ; salt water baths ; 
frictions with a coarse towel; open air exercise, and light gymnas- 
tics. The side of the neck opposite the inclination should be 
thoroughly rubbed with stimulating liniments or ointments, such as 
given in Part IV. 

Erysipelas, a boil, a burn, or similar injury, or rheumatism, may 
either weaken the muscles of one side of the neck, or, by rendering 
their exterior painful, lead to " favoring" them by holding the head 
bent toward that shoulder. Therefore, whenever a child has such 
an injury in that locality, he should be watched, and this tendency 
prevented by prompt admonition, or by bandages and mechanical 
appliances. The latter, together with the surgical operation of 
dividing the muscles, is the resort of the physician in cases where 
the milder means we have mentioned fail. 

Sore Eyes, or Ophthalmia. Not a few children, especially those 
who have in their constitutions a somewhat scrofulous taint, suffer 
from soreness, redness, and weakness of the eyes. In the morning 
they complain that the lids are "stuck together;" in the evening 
that they smart and burn. A bright light is painful to them, and 
they are frequently seen rubbing the eye, as if there was something 
irritating in it. On separating the lids, we can see that an unnatu- 
ral redness is present, both on the edges of the lids and over the 
white of the eye. Small, red veins may be seen winding through 
the latter, and the lids often look thicker than is natural. 

How Treated. Having satisfied ourselves by a careful examina- 
tion, as directed on a previous page, that these symptoms do not 
arise from the presence of some foreign body in the organ, in which 
case its removal will cause the symptoms to disappear, we proceed 
to treat the eye locally, by an appropriate eye-wash. Clear, cool 
water is one of the best ; water which contains a tablespoonful of 
salt to the quart, and mucilage water made by soaking an ounce of 
sassafras pith to the pint, are all simple and efficient eye-washes. 
Care should be taken that they freely run over the ball of the eye. 
The lids should be held apart, and the wash applied in a gentle 



Cross Eyes. 309 

stream several times a day. When there is a scrofulous taint, re- 
course must be had to internal remedies and more active lotions. 
What we have said under Scrofula, in a previous chapter, will 
answer for the first. For the second, the eye-washes, Nos. 122, 
123, 124, 125, page 346, will be found of great value. Salt water 
or mustard foot-baths often yield good service by drawing the in- 
flammation from the eye. The bowels must be kept somewhat 
loose. The child should be warned not to use the eyes in any 
manner which causes pain. If light becomes quite painful, he must 
be kept in a darkened room. By such precautions he will be re- 
stored early, and avoid one of the saddest accidents to which man is 
liable — the loss of sight. 

Cross Eye, Squint, Squinting, Strabismus. These names are 
given to a turning or deviation of one eye from the line of vision 
of the other. It is readily seen by an observer, and casts an 
unpleasant expression on the face of the sufferer; more than that, 
it is sure, sooner or later, to weaken the eyesight. It may arise 
from injury, but much more frequently it is caused by the bad 
habit contracted in early childhood of using only one eye, closing 
the other, or not fixing it on the object. An infant frequently 
laid on a bed on the one side of which is a blank wall and on the 
other a window, will use the eye toward the latter and not that 
toward the former, and thus may contract a permanent squint. 
Babes should always be placed in such a position toward the light 
that they shall use both eyes equally. 

Older children, if the one eye becomes inflamed from a foreign 
body or other cause, very easily acquire the same habit, and must 
be closely watched in consequence. Violent mental emotions in 
nervous temperaments have the same tendency to cause squinting. 

How Treated. Much can be done in early childhood to check 
cross-eye, by means of certain exercises, with the view of restoring 
the crooked eyes, consisting in directing the sight along different 
lines of vision, inward, outward, upward, and downward; by 
urging the child to be on his guard against using one and not the 
other organ. These means failing, an operation is the only recourse ; 
the proper age at which it should be done is from twelve to fourteen 
years. 



3 10 Diseases of Children. 

Ingrowing Eyelashes. Children who have suffered from 
inflammation of the eyes, and others who have not, are occasionally 
much annoyed by the tendency of some of the hairs which form the 
eyelashes to turn inwardly and thus irritate the ball of the eye. It 
leads to a sense of pricking and an irritable and watery state of the 
eye. To remedy this, the offending hairs must be carefully plucked 
out from time to time. This seems a simple and trifling matter, 
but, in fact, few manipulations require more care. The hair must 
not be broken, as its stiff stump will cause far more distress than 
its natural fine point. A pair of delicate forceps should be used, 
the hair grasped firmly between their poiuts, and never be sharply 
jerked out, but removed with a slow, steady pull. 

Styes, to which we have already referred, are peculiarly prone 
to appear on scrofulous and delicate children. They are minute 
boils which appear on the very edge of the lid, as small, red, tense 
swellings, with a sense of itching and stiffness. Sometimes, the 
inflammation excited entirely closes the eye, and considerable pain 
follows. 

A stye should never be rubbed or squeezed ; no incision is neces- 
sary; all that is required is a warm water dressing, applied by 
means of the bandage shown in Figure 93, page 240. The bowels 
should be kept regular by some of the many means we have 
recommended, the diet carefully regulated, and tonics, as of iron or 
quinine, be given for some time. 

Running from, or Catarrh of the Ears. The inside of the 
ear has a natural secretion of wax, which serves to protect it in a 
variety of ways. In children, especially feeble and scrofulous ones, 
that secretion is liable to become increased in quantity, fluid or 
watery, and offensive to sight and smell. A great deal of injury is 
done by attentive mothers and nurses, who think the ears of children 
require to be cleaned out, by inserting into them the screwed-up 
corner of a towel. Dr. Hinton, of London, who has given much 
attention to diseases of the ear, says, " This practice may rank next 
to scarlatina among the causes of disease of the ear in children." 

Local applications in such cases must be very carefully employed. 
Astringent injections are liable to do more harm than good. Atten- 



Crushed Fingers. 3 1 1 

tion to the general health, and a few drops of sweet oil poured in 
the ear, from time to time, are sufficient. 

Another form of running from the ears arises from inflammation 
of the lining membrane of the canal of the ear. Poor and neglected 
children have this very commonly, and it may follow scarlatina in all 
classes. It is distinguished from the former by being preceded by 
uneasiness and pain in the passage, frequent spells of " earache," a 
sensation of itching, which leads the little patient to run his fingers 
and other objects in his ears, and the swollen appearance of the 
inside of the ear when examined in a strong light. The hearing is 
not generally impaired. The general health is almost always 
deranged. The discharge is not thin and waxy, as in the preceding 
variety, but is semi-purulent or mattery, often with a foul odor. 

In this form, washing out the ear with a gentle astringent lotion 
is needed. The use of the syringe requires considerable care, on 
account of the tenderness of the parts, especially in children ; it is 
best not to employ it. The child should lie down on the side 
opposite the diseased ear, and this should then be filled with the 
lotion by simply pouring it in. After it has remained in for two 
or three minutes, the child may turn and let it run out. As an 
appropriate lotion, use may be made of white oak bark tea, cold or 
warm ; or, of water one pint, powdered alum one teaspoonful ; or, 
of water one tumbler, sugar of lead ten grains. These lotions 
should be used three or four times a day, in the manner prescribed, 
and attention given to the general health of the child. 

For the attacks of earache which accompany this disease, or 
precede it, the best application is heat. This can be applied in any 
of the ways mentioned on page 347 ; or, what we think a most 
excellent and convenient means, wrap a hot roasted onion in a 
flannel wrung out in laudanum, and bind it over the ear. 

Crushed Fingers. The very common accident here mentioned 
may vary from a mere pinch to a crush which will leave one or 
more fingers or the whole hand a shapeless mass. No matter how 
severe it may be, the attendants must not despair. The hand, that 
"divine tool," as it has been called, is too important a member to 
be given up without the most strenuous exertions. Moreover, the 
experience of the last ten years has proven over and over again 



3 1 2 Diseases of Children. 

that the most hopeless-looking crushings have been successfully 
treated by simple measures. That which should be employed 
beyond all else is icater. Constant irrigation (as explained in 
chapter VI) should at once be commenced, using cold water in 
warm seasons and moderately warm water in cold seasons, taking 
care not to cease it abruptly, but at the end of three days dimin- 
ishing gradually. The hand and fingers should be placed in a 
splint that will keep them motionless, and may be dressed with 
linen spread with clean lard, fresh, unsalted butter, or cerate. 
After the first inflammation has subsided, cloths wet with alcohol 
and water, carbolic acid and water (teaspoonful of carbolic acid to 
the quart), or the like stimulating lotions, may be employed. If 
proud flesh (''fungous grauulation," as it is called by surgeons) 
appears, it may be checked by touching with burnt alum. Great 
cleanliness is essential. The strength should be kept up by nour- 
ishing broths and milk, and by stimulants, if the former do not 
suffice. Sleep should be secured by some of the means already 
mentioned, and the little sufferer placed in as comfortable a 
position as possible. 

Hip Disease. The painful affection commonly known by this 
name is an inflammation of the hip-joint, passing into suppuration 
and a destruction of the head of the bone. It is essentially a dis- 
ease of childhood, rarely commencing before the age of four years, 
and equally rarely after fourteen. The sufferers are most commonly 
of scrofulous constitutions, and generally feeble health; but the 
affection may arise in healthy children, in which case it can gene- 
rally be traced to a blow, fall, or strain. The progress of the dis- 
ease is usually slow, lasting for many years, and when a cure is 
obtained it is rarely accomplished until the age of puberty. Dur- 
ing the earlier stages of the disease the patient may retain nearly 
all the appearances of perfect health, hence it is important that 
parents should learn to recognize what its first signs are. These 
are a slight lameness or limping, often amounting to nothing more 
than "favoring" one leg more than, another, as in standing with the 
weight thrown on one in preference to the other; some little pain 
in the limb, which, however, is more frequently referred to the 
kuee or its vicinity than to the hip ; an appearance, when stripped, 



Spinal Diseases. 313 

of having one leg a little shorter or longer than the other, and a 
slight difference in the contour of the buttocks. In sleeping, the 
child is observed to take, in preference, a position which avoids 
throwing the weight on the affected joint, and if turned so as to 
rest upon it, will unconsciously throw himself back in order to re- 
move the pressure. These symptoms, coming very gradually, 
may justly cause alarm, and the child should be submitted to the 
examination of a competent surgeon without delay. 

Of the treatment, it need only be said that it must be directed to 
remove all pressure from the affected joint, that is, the child mast 
be put into splints that will maintain its leg and thigh motionless 
for a long time. The apparatus to secure this end is complicated, 
and can only be applied by a professional man. We therefore omit 
its description. 

Spinal Diseases. These nearly always commence in childhood, 
and as they are insidious and slow in progress, often progress be- 
yond remedy before attention is directed to them. 

Curvature of the spine is easily caused by occupations or pos- 
tures that tax one side of the body more than the other, especially 
if at the same time the child is subjected to want of exercise. Sit- 
ting in school at too high or too low desks, and working in factories 
in constrained positions, are common causes of it. The first thing 
that attracts attention is a projection of one shoulder-blade or the 
other, cr an elevation of one shoulder above the other, or of one 
side of the bosom, which is popularly said to be "growing out." 
The age at which it is generally noticed is from ten to sixteen. If 
the back be now exposed and the spine examined, it will be found 
to be curved from a straight line into one like the italic letter /, 
which will be seen to be the reason of the projection of the shoul- 
der blade, etc. 

The cure will depend chiefly upon removing the habit or neces- 
sity of using one side more than the other, giving the body rest, 
and on maintaining good general health. The child should sleep 
with a single pillow, so that the body be not bent; gentle and regu- 
lar exercise in the open air should be practiced every day ; standing 
or sitting in one position, for any great length of time, must be 
avoided; and the back should be rubbed every mornin^ with a 

27 



3 H Diseases of Children. 

coarse towel or horse-hair gloves. The clothes should he supported 
in some easy and natural manner. The many "braces" and stays 
which are advertised should be avoided, as generally they do more 
harm than good. 

Inflammation of the spine is a disease which generally affects 
scrofulous children, but may arise from a blow upon the backbone, or 
a fall upon it. It begins with a feeling of languor, weakness, and 
coldness in the legs ; inability to stand erect for any length of time ; 
_,i«:ness and shuffling in the gait ; disturbed sleep ; costive bowels ; 
and soreness in the back. If now the latter be examined by press- 
g with the finger on each process or vertebra of the backbone 
(see p. 49), one or two of them will be found tender on pressure, 
nd perhaps a little more prominent than the others. 

The treatment which is required is rest in bed in a horizontal 
position, and keeping the strength up with tonics, iron, etc. The 
^ooner this is commenced and rigidly enforced, the better prospect 
is there of a cure. 

$)ropsy of the spine, or "spina bifida," is an affection with which 
some infants are born. There is a watery tumor on the backbone, 
at some point of its course, tender on pressure, and causing a loss 
of power of movement. Such children occasionally survive to 
adult life, but the complaint is incurable, and the probabilities of 
early death very strong. 

Club Foot. This affection consists in a deformity of the foot, 
by which the part that touches the ground is not the sole, but the 
side of the ball or the heel. Generally, children come into the 
world with this malformation, but sometimes it is a consequence of 
fever, of long confinement and inactivity, of attacks of rheumatism, 
and even of irritation of the bowels or of the foreskin. Slight 
cases may generally be remedied, if taken at their very commence- 
ment, by daily extension with the hands, and frictions of stimulat- 
ing liniments, together with tonics, electricity, and sea bathing. 
"When these measures do not succeed, a surgical operation is neces- 
sary, which, by cutting the muscles which retain the foot in its 
false position, allows it to be righted. 

Weak Ankles. This affection depends upon a weakness or 
relaxation of the bones and ligaments of the ankles, rendering the 



Rupture. 3 1 5 

internal border of the foot convex or concave, so that the child 
walks on one or other side of it. It is almost sure to be brought 
on if children are put upon their legs too soon, and persuaded to 
try and walk before their lower _ limbs have the requisite strength. 
In its treatment, the patient should wear shoes or boots with high 
heels, and with the inner edge of the sole much thicker than the 
outer. In severe cases, he must wear a tight-fitting boot, with a 
piece of whalebone or a frame of steel passing up to the middle of 
the leg, thus firmly fixing his foot in its natural position. This 
will have to be worn continuously, from six to eighteen months, 
before the cure is permanent. 

Knock-Knee, or In-Knee. This frequent deformity, not con- 
fined to childhood, but most frequent then, consists of an inward 
yielding of the knee-joint, in consequence of the weakness of the 
ligaments and muscles destined to keep it in its proper place. It 
may be constitutional, arise from strains and such-like accidents, or 
be caused by insufficient nutrition. Putting an infant on a watery, 
floury diet, when it ought to have breast-milk, is a common link in 
the chain of causes to which it may be traced. It may proceed 
to such an extent that the child, at the age of eight or ten, is pre- 
vented from walking altogether without the use of crutches. 

In a small proportion of cases, children recover from this deform- 
ity without any treatment. The probabilities of this fortunate 
result are much increased if the exciting cause of the complaint is 
removed, and the child placed under favorable hygienic surround- 
ings. When this fails, mechanical support must be given. For 
this purpose simple padded wooden splints may suffice, a short one 
behind the knee, to prevent its flexion or bending backward, and a 
long one, reaching from the hip to the ankle, on the outer surface 
of the limb. They must be firmly, but not too tightly bandaged. 
Care should be taken to employ daily friction, and passive motion 
(p. 247), to prevent the joint from becoming stiff. In still more 
severe cases, a somewhat complicated apparatus of iron or steel is 
used, which it is needless to describe. 

Rupture, or Hernia, may occur in children from the time of 
birth, or may be developed at any age, in those predisposed, after 
unusually violent exercise, as leaping, wrestling, or riding. When- 



3 i6 Diseases of Children. 

ever a child is observed to have a slight tumor or swelling at the 
navel, or in the groin, enlarging on coughing or straining, he should 
be warned of the risk of violent effort, and the first opportunity 
embraced to consult a competent surgeon. The permanent cure of 
a rupture, by means of a properly fitting trass, is more likely to be 
brought about in a child than in grown persons. 

In very young children a rupture at the navel is not uncommon. 
It may appear a few days after birth. When a child presents this 
infirmity, it must be removed by compression. This is accom- 
plished by a well-fitting bandage around the waist, containing a coin 
or similar body immediately over the navel, thus retaining the parts 
in their natural positions. 

When they occur elsewhere, ruptures must be treated on the 
principles laid down, p. 232. 

Cancer, although not specially an affection of childhood, is li- 
able to occur at that time, and moreover, as a disease generally here- 
ditary, may be appropriately spoken of in this connection. Cancers 
are of various kinds, and may occur in all parts of the body, and 
appear at any age. They have been described as hard, soft, open or 
bleeding, black, skin and bone cancers. They usually commence 
with a swelling and pain, followed by a breaking of the skin, and 
the formation of an external running sore. The pain is a very 
variable symptom. At the outset it is rarely very severe, and may 
not be continuous. At times, it is described to be of an aching or 
rheumatic character; at others, and more commonly, it is an occa- 
sional dart of pain through the part, as if a needle had suddenly 
been thrust into it. Later in the disease, the suffering becomes 
severe and constant, even excruciating, and can only be relieved by 
heavy doses of opiates. 

What makes cancers so dangerous, is their tendency to recur 
after removal, and penetrate into and poison the tissues of all the 
organs of the body. Hence the only hope is to treat them early, 
before this has come to pass. Although generally hereditary, they 
are, in their outbreak, entirely local, and many instances are on 
record where early and complete removal has saved the patient from 
any recurrence of the cancerous growth. 

One of the most common forms of cancer is epithelial, or skin 



Swellings of the Glands of the Neck. 317 

cancer. It is frequently seen on the lips and face. Its surface may- 
be dry and warty, or watery and ulcerating. The edges are thick 
and a little elevated, and the discharge thin. It is usually slow in 
progress, lasting for years before causing such serious inconvenience 
as to lead the sufferer to a surgeon. 

The treatment of a cancer, whether in a child or in an adult, is 
always and only by removal, and the earlier and more completely 
this is done, the greater safety has the patient for his life. Removal 
may be accomplished either by the knife or by caustics. Of the 
first of these methods, we shall only say that in the majority of 
cases it is the least painful, the most prompt, and the most effica- 
cious. Whenever it is possible, the advice of a good surgeon 
should be sought early, and his intervention solicited. 

But many people have a great dread of the knife. They prefer 
to suffer indefinite agonies from strolling quacks who advertise can- 
cer salves, and it is of these we would speak. Whatever secrets 
such quacks pretend to have, they are all deceptions, and unscrupu- 
lous frauds. The caustics which are of use in cancer are all well 
known to the regular medical profession, and appear in the text- 
books of surgery. The two principal ones are the chloride of zinc 
and arsenic. The former, made into a paste with two parts of flour 
and a small quantity of morphia, is as efficient a cancer salve as 
any, but it is dangerous and unjustifiable for persons ignorant of 
surgery to employ it. Of the internal remedies given to prevent 
the return of cancer, the best are arsenic, in small doses, long con- 
tinued, and poke root. The latter vegetable preparation, given as a 
tea or extract, seems to have really valuable properties. 

Swellings of the Glands of the Neck are often treated at 
home, without the aid of the physician or surgeon, until they 
suppurate, and are likely to leave scars. When such domestic 
management, however, is determined upon, the invalid should be 
allowed a nutritious animal diet, his bowels kept free by exercise 
on foot, whilst mild purgatives should be given, and the solution of 
iodide of iron, in doses of from ten to sixty drops, or the syrup of 
the iodide, in doses of a teaspoonful (a fluid drachm, which contains 
three grains of the iodide), should be internally administered, in a 
glass of water, twice a day. The tumors should be treated with 
27* 



3i8 



Diseases of Children. 



fomentations of salt or sea water, and friction employed twice daily, 
for half an hour each time. If suppuration cannot be arrested, 
under the improved state of health, then surgical advice must not 
be delayed until the abscess bursts spontaneously, for an ugly scar 
is likely to be the 'result; an event always to be regretted, especially 
in females. 




PART IV. 
SPECIAL RECEIPTS FOR CARE OF THE SICK. 



THE DIVISIONS OF THIS PART. 



In this, the last of the four parts into which we have divided our 
book, we have grouped nearly three hundred new and approved 
special receipts for the care of the sick. The first chapter of this 
part, Chapter Eleventh of the book, contains choice -dietetic receipts 
for the sick-room ; the second chapter of this part, Chapter Twelfth 
of the book, contains efficient medical receipts for the sick-room. 
Most of these receipts have been referred to by their numbers, in 
the treatment recommended for the various ailments discussed on 
the previous pages. By grouping them, as is here done, the 
various ways for accomplishing the same or a similar object are 
shown, and the reader can readily choose among them, in accordance 
with the purpose in view or the resources at hand. Thus, if a poul- 
tice is wanted, by turning to the section on poultices, in Chapter 
Twelfth, there will be exposed at one view, under the eye, a large 
number of receipts for making poultices, from which to select one 
appropriate to the needs of the case, or to the means of treatment 
at command. 

319 



<r^T>^e^e/-^ 




CHAPTER X 

Dietetic Receipts for the Sick Room. 

Importance of the subject — Rules for preparing and serving food for the 
sick — Nutritious, cooling, and soothing drinks: Lemonade— Effervescing 
lemonade — Barley water — Linseed tea — Arrowroot drink — Milk punch — 
"Wine whey — Egg and sherry — Ice — Toast and water — Nutritions coffee — 
Milk and Isinglass — A soothing drink — Milk and cinnamon drink — 
Caudle — Apple water — Chocolate — Chocolate milk — The Invalid's tea — 
Hose tea — Sage tea — Oatmeal tea. Gruels : Water gruel — Milk gruel — 
Flour gruel— Rice gruel— Barley gruel. Broths and soups: Chicken 
broth — Mutton broth— Whole beef tea— Quickly-made beef tea— Veget- 
able soup— Bread soup— Spinach soup — Beef and hen broth. Meats and 
Vegetables for Invalids : Table, in order of digestibility, of some articles 
of animal food — Boiled pigeon or partridge — Bread sauce — Itelish for 
fish— Minced fowl and egg— Fowl and rice— Stewed oysters— The inva- 
lid's cutlet— The invalid's mashed potato — Potato surprise Jellies for 
Invalids: Isinglass jelly— Strengthening jelly— Mutton jelly— Bread 
jelly — Rice blanc-mange— Arrowroot blanc-mange — Sago jelly — Tapioca 
jelly — Panada— Calves' feet jelly— Currant jelly— Irish moss blanc- 
mange— Gelatine blanc-mange. Puddings for Invalids: Rice pudding- 
Bread pudding— Batter pudding — Mihk for puddings or stewed fruit — 
Rice and apple — Vermicelli pudding. 

In many, if not in all diseases, the choice and the preparation of 
the articles for the patient's table are of the utmost importance. 
Food is often the best medicine, and the cook may frequently be 
of more service than the druggist. But not uncommonly, the dishes 
served the invalid, like the drugs administered to him, fail of their 
effect because of their fralty preparation. Those who cook for the 
sick share the responsibility of treatment with the physician and 
pharmacist. 

The character and amount of the food required by the sick 
vary, of course, with the nature and stage of the illness. Those 
sick of a, fever need to be nourished by frequent supplies of nutri- 
320 



Rules for Waiting on the Sick. 321 

tious, easily digested food, in a fluid form, for solid food is, ordina- 
rily, then rejected by the stomach, because of the loathing it 
excites. The weakest stomach, in such case, will take a small 
wineglassful of milk or beef-tea, every hour or two. If the milk 
clot in the stomach, and cheesy lumps be thrown up, this can be 
readily guarded against by adding a tablespoonful of lime water to 
each wineglassful of milk. As no regular meals can be taken, they 
should not be attempted. Small quantities of fluid food at short 
intervals, will furnish, during the twenty-four hours, a large amount 
of nourishment, which the irritable stomach, when thus approached, 
will absorb unconsciously. In inflammatory rheumatism, meat in 
any form, solid or fluid, is injurious; the patient must be put upon 
preparations of rice, potatoes, bread, arrowroot, gruel, vegetable or 
meatless soups, and jellies. In dyspepsia and weak digestion, the 
invalid requires frequent, small meals, at which he should drink 
very sparingly, and not at all at the beginning of the repast. 
Persons subject to hysterics need a generous meat diet, and must 
avoid all spirituous or fermented liquors. An excellent drink for 
them is a mixture of equal parts of soda water and milk. For 
consumptives, milk and suet are excellent articles of diet, but the 
best of all is cod-liver oil, which is the most readily digested fat of 
which we have any knowledge. In disease of the heart, a dry diet 
is most conducive to the comfort of the invalid, as liquids are 
absorbed very slowly by the stomach ; the table should be generous, 
from which stimulants, however, are to be excluded, as they readily 
excite the heart's action. 

We cannot better preface the varied receipts of this chapter, 
than by quoting the words of one whose eminence in the profession, 
and whose large and long experience, give them the weight of author- 
ity. Professor Gross says : " The diet of the sick room has slain its 
thousands and tens of thousands. Broths, and slops, and jellies, 
and custards, and ptisans, are usually as disgusting as they are 
pernicious. Men worn out by disease and injury must have 
nutritious and concentrated food. The ordinary preparations for 
the sick are, in general, not only not nutritious, but insipid and 
flatulent. Animal soups are among the most efficient supporters 
of the exhausted system, and every medical man should know how to 



322 Special Receipts for the Care of the Sick. 

give directions for their preparation. The life of a man is his food. 
Solid articles are, of course, withheld in acute diseases, in their 
earlier stages ; hut when the patient begins to convalesce, they are 
frequently borne with impunity, and greatly promote recovery. All 
animal soups should be made of lean meat; and their nutritious 
properties, as well as their flavor, may be much increased by the 
addition of some vegetable substance, as rice or barley. If the 
stomach is very weak, they may be diluted, or seasoned with 
pepper." 

The following rules must be observed in preparing, cooking, and 
serving food for the sick: — 

All the utensils employed should be scrupulously clean. 

Never make a large quantity of one thing at a time. 

Serve everything in as tempting and elegant a form as possible. 

Put only a small quantity of an article on a dish at a time. 

Keep milk and other delicacies on ice in warm weather. 

Never leave food about a sick room. 

Never offer beef tea or broth with the smallest particle of fat or 
grease on it, nor milk that is sour, nor meat or soup that is turned, 



NUTRITIOUS, COOLING AND SOOTHING DRINKS. 



1. Lemonade. 
Take of 

Sugar, two or three lumps. 

Lemon, one. 

Well rub the sugar on the rind of 
the lemon, squeeze out the juice, and 
add to it halt* a pint or a pint of 
cold or iced water; or, better still, 
one or two bottles of soda water. 

2. Another Lemonade. 
Pare the rind of three lemons as 
thin as possible, add a quart of boil- 
ing water and a quarter of an ounce 
of' isinglass. Let them stand till 
next day, covered, then squeeze the 
juice of eight lemons upon half a 
pound of lump sugar; when the 



sugar is dissolved, pour the lemon 
and water upon it, mix all well to- 
gether, strain it, and it is ready for 



3. Effervescing Lemonade. 
Squeeze two large lemons, and add 
a pint of spring water to the juice, 
and then four or five lumps of white 
sugar. When required for use, pour 
half of it into a tumbler, and add 
half a teaspoonful of baking soda; 
stir and drink while foaming. 

4. Barley Water. 
Take of 
Pearl barley, half a quarter of a 
pound. 



Nutritions, Cooling and Soo tiling Drinks. 323 



Wash with, cold water. Boil for 
five minutes in some fresh water, 
and then throw both waters away. 
Then pour on two quarts of boiling 
water, and boil it down to a quart. 
Flavor with thinly-cut lemon rind, 
and sugar to taste, but do not strain, 
unless at the sick person's special 
■request. 

This is an excellent receipt for 
making hard water more digestible. 

5. Linseed Tea. 

Take of 

Whole linseed, 

White sugar, each one ounce. 

Liquorice root, half an ounce. 

Lemon juice, four tablespoonfuls. 

Pour on the materials two pints of 
boiling water, let them stand in a hot 
place four hours, and then strain off 
the liquor. 

This makes an admirable soothing 
drink, which acts also upon the kid- 
neys, 

6. Arrowroot Drink. 

Take of 

Arrowroot, two teaspoonfuls. 

Cold water, three tablespoonfuls. 

Mix together and pour in about 
half a pint of boiling water. When 
well mixed, add, by degrees, half a 
pint of cold water, stirring all the 
time, so as to make it perfectly 
smooth. It should be about the 
consistence of cream ; if too thick, a 
little more water may be added. 
Then pour in two wineglassfuls of 
sherry, or one of brandy, add sugar 
to taste, and give it to the invalid in 
a tumbler. A lump of ice may be 
added. 

7. Milk-Punch. 
Take of 

Good brandy, two tablespoonfuls. 

Cold, fresh milk, one tumblerful. 

Mix with sugar and nutmeg to 
taste. 

This is a useful drink when a 
stimulant is required in conjunction 
with a nutrient. It is a medicinal 
drink, and must not be given indis- 
criminately. 

8. Wine Whey. 

Take of 

Fresh milk, one pint. 

Boil it, and so soon as the boiling 



point is reached add as much good 
Madeira or sherry as will coagulate 
it. Strain, and sweeten or flavor 
for use. 

This preparation, when nicely 
made, renders great service to the 
siek in proper cases. 

9. Egg and Sherry. 

Beat up, with a fork, an egg till it 
froths, add a lump of sugar and two 
tablespoonfuls of water. Mix well. 
Then pour in a wineglassful of 
sherry, and serve before it gets flat. 
Half the quantity of brandy may be 
used instead of sherry. 

This is a valuable preparation in 
cases of great prostration, when 
stimulants and concentrated nutri- 
ment are required. 

10. Ice. 

It has been found by experiments 
on the gastric juice that low tempera- 
ture does not exercise any deleterious 
influence upon it, though it is quite 
spoiled by heat. The supply of the 
juices necessary to digestion is ar- 
rested by feverishness of the system 
and in hot weather and in hot rooms. 
It cannot, therefore, but be benefi- 
cial to the stomach to reduce the 
unusual temperature to which it has 
been brought by the overheated 
blood. Hence, ice makes a most 
valuable addition to the tables of 
both sick and well. It is very inju- 
rious during the exhaustion follow- 
ing violent exercise, or the real cool- 
ing attending excessive perspiration. 
Lake ice is much superior to pond 
ice or snow. 

11. Toast and Water. 
Take of 

Bread, one slice, from a stale loaf. 

Boiling water, one quart. 

Toast the slice of stale bread (a 
piece of hard crust is better than 
anything else for the purpose) to a 
nice brown on each side, but do not 
allow it to burn or blacken. Put it 
into a jug, pour the boiling water 
over it, cover it closely, and let it 
remain until cold. When strained 
it will be ready for use. 

Toast and water should always be 
made a short time before it is re- 



324 Special Receipts for the Care of the Sick. 



quired, to enable it to get cold ; if 
drank in a tepid or lukewarm state, 
it is an exceedingly disagreeable 
beverage. If, as is sometimes the 
case, this drink is wanted in a hurry, 
put the toasted bread into a jug, and 
only just cover it with the boiling 
water ; when this is cool, cold water 
may be added in the proportion re- 
quired, and the toast and water 
, strained. It will then be ready for 
use, and is more expeditiously pre- 
pared than by the above method. 

12. Nutritious Coffee. 

Dissolve a little isinglass in water, 
then put half an ounce of freshly- 
ground coffee into a saucepan, with 
one pint of new milk, which should 
be nearly boiling before the coffee is 
added. Boil both together for three 
minutes. Clear it by pouring some 
of it in a cup and dashing it back 
again. Add the isinglass and leave 
it to settle before the fire for a few 
minutes. Beat up an egg in a break- 
fast cup and pour the coffee into it; 
or, if preferred, drink without the 



13. Milk and Isinglass. 
Take of 

Isinglass, a pinch or two. 
Milk, a tumblerful. 
Mix well and boil. Serve with or 
without sugar, as preferred. 

14. A Soothing Drink. 
Take of 

Isinglass, a pinch. 
New milk, a tumblerful. 
Bruised sweet almonds, half a 

dozen. 
Sugar, three lumps. 
Boil together. 

15. Milk and Cinnamon Drink. 

Boil, in a pint of new milk, suffi- 
cient cinnamon to flavor it pleasant- 
ly, and sweeten with white sugar. 

This may be taken cold, with a 
teaspoonful of brandy, and is very 
good in cases of diarrhoea. Children 
may take it milk-warm, without the 
brandy. 



16. Caudle. 

Beat up an egg to a froth, add a 

wineglassful of sherry, and half a 

pint of gruel; flavor with lemon-peel 

and nutmeg, and sweeten to taste. 

17. Apple Water. 
Slice two or three ripe apples, 
without paring, into a pitcher, pour 
on a quart of scalding water, let it 
stand till cool, and sweeten with 
sugar. 

18. Chocolate. 
Put milk and water on to boil. 
Scrape the chocolate fine, one or two 
squares to a pint, as will best suit 
the stomach. When the mixture of 
milk and water boils, take it off the 
fire, throw the chocolate into it, mix 
it well, and serve it up with the froth. 

; The sugar may be mixed with the 
scraped chocolate, or added after- 

| wards. It should never be made 
before it is wanted, as heating it 
again injures the flavor, and causes 
a separation of the oil. 

19. Chocolate Milk. 
Dissolve an ounce of scraped choco- 
late in a pint of boiling new milk. 

20. The Invalid's Tea. 
Pour into a small china or earthen 
ware teapot a cup of quite boiling 
water ; empty it out, and while the 
teapot is still hot and steaming, put 
in the tea. Add enough boiling wa- 
ter to wet the tea thoroughly, and set 
it close to the fire to steam, for five or 
six minutes. Then pour in the quan- 
tity of boiling water required, from 
the kettle, and it is ready for use. 

21. Rose Tea. 
Take of 
Red rose-buds ("the white heels 
being taken off), half an ounce. 
White wine vinegar, three table- 
spoonfuls. 
White sugar candy, one ounce. 
Put them in two pints of boiling 
water, and let them stand near a fire 
for two hours, then strain. 

Similar sour drinks may be made 
of apple jelly, guava jelly, syrup of 
gooseberries, etc. A "variety is 
always agreeable. 



Gruels for Invalids. 



325 



22. Sage Tea. 

Take of 
Green sage leaves, plucked from 
the stalks and washed clean, half 
an ounce. 
Sugar, one ounce. 
Outer rind of lemon-peel, finely- 
pared from the white, quarter of 
an ounce. 
Put them in two pints of boiling 
water, let them stand near the fire 
hal r an hour, then strain. 

When the sage is dried, it must be 
used in rather less quantity than 
above mentioned. 
In the same manner, teas may be 



made of rosemary, balm, southern 
wood, etc., and are convenient to 
prevent a thirsty invalid taking too 
much tea and coffee when not good 
for him. 



23. Oatmeal Tea. 

Take of 

Oatmeal, a handful. 

Barley water, a gallon. 

Mix in a deep vessel. Let the 
oatmeal subside, which it does in 
half an hour, and pour off the tea. 
Hard water may be made digestible 
in this manner. 



GRUELS. 

Gruels should be thick, but not too thick ; thin, but not too 
thin. Served in a tumbler they are more appetizing than when 
served in a basin or cup and saucer. 



24. Water Gruel. 

Take of 

Fine oatmeal, a dessertspoonful. 

Cold water, a tablespoonful. 

Mix. Add a jfint of boiling water, 
and boil it ten minutes, keeping it 
stirred. 

25. Milk Gruel. 
Take of 

Fine oatmeal, four tablespoonfuls. 

Milk, a quart. 

Stir the oatmeal smoothly into the 
milk. Then stir it quickly into a 
quart of boiling water, and boil up a 
few minutes, till it is thickened. 
Sweeten with sugar. 

26. Flour Gruel. 
Take of 

Flour, a tablespoonful. 

Water, half a tumblerful. 

Mix smoothly. Set on the fire, in 
a saucepan, half a tumblerful of new 
milk, sweeten it, and, when it boils, 
add the flour and water. Simmer 
and stir them together for a quarter 
of an hour. 

27. Rice Gruel. 
Take of 

Fine rice, two tablespoonfuls. 

28 



Soak for half an hour in cold 
water. Pour off the water, and to 
the rice add a pint, or rather more, 
of new milk. Simmer gently till the 
rice is tender, then press through a 
sieve and mix with the milk, Heat 
over the fire, add a little more milk 
gradually, pour off to cool, and 
flavor with salt or sugar. 



28. Barley Gruel 

Take of 

Pearl barley, two ounces. 

Port wine, a tumblerful. 

Rind of lemon, one. 

Water, one quart and a pint. 

Sugar, to taste. 

After well washing the barley, boil 
it in a tumblerful of water for fif- 
teen minutes. Then pour this water 
away. Put to the barley the quart 
of fresh boiling water, and let it 
boil until the liquid is reduced to 
half; then strain it off. Add the 
wine, sugar and lemon peel. Sim- 
mer for five minutes and put it away 
in a clean jug. It can be warmed 
from time to time, as required. 



326 Special Receipts for the Care of the Sick. 

BKOTHS AND SOUPS. 

Broths, soups and beef tea should not he kept hot, but heated 
up as required. Neither should they ever be made in the sick 



29. Chicken Broth. 

Skin, and chop up small, a small 
chicken, or half a large fowl, and 
boil it, bones and all, with a blade 
of mace or sprig of parsley, and a 
crust of bread, in a quart of water, 
for an hour, skimming it from time 
to time. Strain through a coarse 
cullender. 

Chicken broth, poured on thin 
pieces of bread laid on the bottom 
of the dish, makes a good sauce for 
boiled chicken or partridge, when 
the invalid is well enough to be 
allowed solid food. 

30. Mutton Broth. 
Take of 

Lean loin of mutton, one pound, 
exclusive of bone. 

Water, three pints. 

Boil gently till very tender, throw- 
ing in a little salt and onion, accord- 
ing to taste. Pour out the broth 
into a basin, and, when it is cold, 
skim off all the fat. It can be 
warmed up as wanted. 

If barley or rice is added, as is 
desirable during recovery from sick- 
ness, it must be boiled first, sepa- 
rately, till quite soft, and put in 
when the broth is heated for use. 

31. Whole Beef Tea. 

The virtue of beef tea is to con- 
tain all the contents and flavors of 
lean beef in a liquid form. Its vices 
are, to be sticky and strong, and to 
set in a hard jelly when cold. 

Take half a pound of fresh-killed 
beef for every pint of tea required, 
and remove all fat, sinew, veins and 
bones. Cut up into pieces under 
half an inch square, and soak for 
twelve hours, in one-third of the 
water. Take it out and simmer for 
two hours in the remaining two- 
thirds of the water, the quantity 
lost by evaporation being replaced 
from time to time. Then pour the 



boiling liquor on the cold liquor in 
which the meat was soaked. Dry 
the solid meat, pound it in a mortar, 
freed from all stringy parts, and mix 
with the rest. 

When the beef tea is made daily, 
it is convenient to use one day's 
boiled meat for the next day's tea, 
as thus it has time to dry and is 
easier pounded. 

A wholesome flavoring for beef 
tea is fresh tomato. A piece of green 
celery stalk, or a small onion and a 
few cloves, may also be boiled in it. 
Leeks give it a fusty flavor, and 
mushroom ketchup, sometimes in- 
troduced, is of doubtful composi- 
tion. 

While this is cooking, some more 
hastily prepared, in the following 
way, may be used. 

32. Quickly-made Beef Tea. 
Take one pound of raw beef, 
minceil, for each pint of water. 
Stir up cold and let it stand for one 
hour. Then place the vessel in 
which they are mixed in a pan of 
water, and heat for another hour, 
over a slow fire, being careful not to 
boil, as then the preparation becomes 
gluey, and is not equally nutritious 
or digestible. Run the tea through 
a coarse strainer, and flavor at dis- 
cretion. 

33. Vegetable Soup. 

Take of butter, half a pound. Put 
it in a deep stew-pan, place it on a 
gentle fire till it melts, shake it 
about, and let it stand till it has done 
making a noise. Have ready six 
medium-sized onions, peeled and cut 
small ; throw them in and shake them 
about. Take a bunch of celery, cut 
in pieces about an inch long, a large 
handful of spinach, cut small, and 
a little bundle of parsley, chopped 
fine; sprinkle these into the pan, 
and shake them about for a quarter 



Meats and Vegetables for Invalids. 



327 



of an hour ; then sprinkle in a little 
flour and stir it up. Pour into the 
pan two quarts of boiling wetter, and 
add a handful of dry bread-crust, 
broken in pieces, a teaspoonful of 
pepper, three blades of mace, beaten 
fine ; boil gently another half hour. 
Then beat up the yolks of two eggs, 
with a teasj>oonful of vinegar, and 
stir them in, and the soup is ready. 

The order in which the ingredients 
are added is very important. 

34. Bread Soup. 

Take the crust of a stale roll, cut it 
in pieces, and boil it well in a pint 
of water, with a piece of butter as big 
as a walnut, stirring and beating 
them till the bread is raised. Season 
with celery and salt. 

35. Spinach Soup. 

Pick all the stalks from one and 
a half pounds of fresh spinach ; wash 



it and clip it ; put it in a three-quart 
stew-pan, with a quarter of a pound 
of butter ; stir it over the fire for five 
minutes ; add an ounce of flour, and 
stir again for three or four minutes, 
then stir in two quarts of chicken 
broth till it boils. Simmer it on a 
cool stove for half an hour, and add 
a small teaspoonful of cream. Serve 
with it some fried or baked bread. 

Endive or lettuce soup may be pre- 
pared in the same way. 

36. Beef and Hen Broth. 

Take of 

Lean beef, one pound. 

Hen, one-half, boned. 

Pound together in a mortar ; add 
salt ; put in a stew-pan with two and 
a half pints of water, and stir over 
the fire till boiling. Then add car- 
rots, onions, leeks, and celery, cut 
fine. Boil for half an hour. Strain 
and serve. 



MEATS AND VEGETABLES FOE, INVALIDS. 



Table, in Order of Digestibility, of 

Some Articles of Animal Food. 
Sweet bread. 
Boiled chicken. 
Venison. 
Lightly boiled eggs, new toasted 

cheese. 
Boast fowl, turkey, partridge and 

pheasant. 
Lamb, wild duck. 
Oysters. 

Boiled haddock, trout, perch. 
Boast beef. 
Boiled beef. 
Bump steak. 
Boast veal. 
Boiled veal, rabbit. 
Salmon, mackerel, herring. 
Hard-boiled and fried eggs. 
Wood pigeon, hare. 
Tame pigeon, tame duck, geese. 
Fried fish. 

Boast and boiled pork. 
Heart, liver, lights and kidneys of 

ox, swine a: 



Lobsters. 

Smoked, dried, salt and pickled fish. 

Crab. 

Bipe old cheese. 

37. Boiled Pigeon or Partridge. 

Clean and season, inclose it in a 
puflf paste, and boil. Serve in its 
own gravy, supplemented by the 
liver rubbed up with some stock, 
and do not forget the bread sauce. 

38. Bread Sauce. 
Take of 

The crumbs of a French roll. 

Water, a tumblerful. 

Black pepper, six to eight corns. 

Onion, a small piece. 

Salt, to taste. 

Boil till smooth ; then add a piece 
of butter about as big as a walnut, 
and mix for use. It is good, hot, 
with hot birds, cold, with cold birds, 
and is an excellent food for the sick. 



32J 



Special Receipts for the Care of the Sick. 



39. Relish for Fish. 
Fish is made more digestible, and 
has its flavor brought out, by a few- 
drops of lemon juice squeezed over 
it. 

40. Minced Fowl and Egg. 
Take of 

Cold roast fowl, one. 

Hard-boiled egg, one. 

New milk or cream, three table- 
spoonfuls. 

Butter, half an ounce. 

Flour, one tablespoonful. 

Salt, pepper, or cayenne, to taste. 

Lemon juice, one teaspoonful. 

Mince the fowl and remove all 
skin and bones. Put the bones, 
skin and trimmings into a stewpan, 
with one small onion, if agreeable to 
the patient, and nearly half a pint 
of water. Let this stir for an hour, 
then strain the liquor, chop the egg 
small, mince with the fowl, add sal* 
and pepper, put in the other ingre- 
dients, let the whole just boil, and 
serve with thin slices of toasted 
bread. 

41. Fowl and Eice. 
Take of 

Eice, one quarter of a pound 

Broth, one pint. 

Butter, one ounce and a half. 

Minced fowl, egg and bread 
crumbs. 

Put the rice into the broth, let it 
boil very gently for half an hour, 
then add the butter, and simmer it 
till quite dry and soft. When cold, 
make it into balls, hollow out the 
inside, and fill them with mince 
made according to the foregoing re- 
ceipt, but a little staffer. Cover with 
rice, dip the balls into egg, sprinkle 
with bread crumbs, and fry a nice 
brown. A little cream stirred into 
the rice before it cools improves it 
very much. 

42. Stewed Oysters. 
Take of 

Oysters, half a pint. 

Butter, half an ounce. 

Cream, one-third of a pint. 

FLmr, cayenne and salt, to taste. 

Scald the oysters in their own 
liquor. Take them out, beard them, 
and strain the liquor. Put the but- I 



ter into a stewpan, dredge in suffi- 
cient flour to dry it up, add the 
oyster liquor, and stir it over a 
sharp fire with a wooden spoon. 
When it boils, add the cream, oysters 
and seasoning, and simmer for one 
or two minutes, but not longer, or 
the oysters will harden. Serve on a 
hot dish, with thin slices of toasted 
bread. A quarter of a pint of 
oysters, the other ingredients being 
in proportion, makes a dish large 
enough for one person. 

43. The Invalid's Cutlet. 
Take of 

Nice cutlet, from loin or neck of 
mutton, one. 

Water, two teacupfuls. 

Celery, one very small stick. 

Pepper and salt, to taste. 

Have the cutlet cut from a very 
nice loin or neck of mutton. Take 
off all the fat, put it into a stewpan, 
with the other ingredients; stew 
very gently indeed for nearly two 
hours, and skim off every particle 
of fat that may rise to the surface 
from time to time. The celery 
should be cut into thin slices before 
it is added to the meat, and care 
must be taken not to put in too much 
of this ingredient, or the dish will 
not be good. If the water is allowed 
to boil fast the cutlet will be hard. 
Time, two hours, very gentle stew- 



44. The Invalid's Mashed Potato. 
Boil one pound of potatoes with 
their skins on, till they are tender or 
brittle. Peel them and rub them 
through a fine sieve. When cool, 
add a small teacupful of fresh cream 
and a little salt, beating up lightly 
until the whole is quite smooth. 
Warm up gently for use. 

45. Potato Surprise. 
Scoop out the inside of a sound 
potato, leaving the skin attached, on 
one side, to the hole, as a lid. Mince 
up fine the lean of a juicy mutton 
chop, with a little salt and pepper ; 
put it in the potato, pin down the 
lid, and bake or roast. Before serv- 
ing (in the skin i add a little hot 
gravy, if the mince seems too dry. 



jfetliesfor Invalids. 



329 



JELLIES FOR INVALIDS. 



46. Isinglass Jelly. 

Boil an ounce of isinglass and a 
dozen cloves (if liked), in a quart of 
water, down to a pint. Strain, hot, 
through a flannel bag, on two ounces 
of sugar-candy, and flavor. 

47. Strengthening Jelly. 

Simmer, in two quarts of soft 
water, one ounce of pearl barley, one 
ounce of sago, one ounce of rice, till 
reduced to one quart. Take a tea- 
cupful, in milk, morning, noon and 
night. 

48. Mutton Jelly. 
Take of 

Shanks of mutton, six. 

Lean beef, half a pound. 

Water, three pints. 

Crust of bread, toasted brown. 

Pepper and salt, to taste. 
' Soak the shanks in water several 
hours, and scrub them well. Put 
the shanks, the beef and other ingre- 
dients into a saucepan, with the 
water, and let them simmer, say, 
gently, for five hours. Strain it, 
and, when cold, take off the fat. 
Warm up as much as is wanted at a 
time. 

49. Bread Jelly. 

Take the crumb of a loaf, break 
it up, pour boiling water over it, and 
leave it to soak for three hours, 
Tiien strain off the water containing 
all the noxious matters with which 
the bread may be adulterated, and 
add fresh. Place the mixture on the 
fire and let it boil till it is perfectly 
smooth. Take it off, and, after pour- 
ing out the water, flavor with any- 
thing agreeable. Put it into a mould, 
and turn it out when required for 
use. 

50. Eice Blano-mange. 
Take of 

Ground rice, one-quarter of a 

pound. 
Loaf sugar, two ounces. 
Butter, one ounce. 
Milk, one quart. 
Flavoring, of lemon peel. 

28* 



Mix the rice to a smooth batter, 
with a little milk, and put the re- 
mainder into a saucepan, with the 
butter, sugar and lemon peel. Bring 
the milk to boiling point, stir in the 
rice. Let it boil for ten minutes, or 
till it comes away from the saucepan. 
Grease a mould with salad oil, pour 
in the rice, let it get perfectly cold, 
and turn out. 

51. Arrowroot Blanc-mange. 
Take of 

Arrowroot, two tablespoonfuls. 

Milk, three-quarters of a pint. 

Lemon and sugar, to taste. 

Mix the arrowroot, with a little 
milk, to a smooth batter; put the 
rest of the milk on the fire and let 
it boil. Sweeten and flavor it, stir- 
ring all the time, till it thickens 
sufficiently to come from the sauce- 
pan. Put it into a mould till quite 
cold. 

52. Sago Jelly. 
Take of 

Sago, two tablespoonfuls. 

Water, one pint. 

Boil gently, until it thickens, fre- 
quently stirring. Wine, sugar and 
water may be added, according to 
circumstances. 



53. Tapioca Jelly. 
Take of 

Tapioca, two tablespoonfuls. 

Water, one pint. 

Boil it gently for an hour, or until 
it assumes a jelly-like appearance. 
Add sugar, wine aud nutmeg, with 
lemon juice to suit the taste of the 
patient and the character of the ail- 
ment. 

54. Fanada. 

Take of 

Bread crumbs, one ounce. 

Mace, one blade. 

Water, one pint. 

Boil, without stirring, till they 
mix and turn smooth. Then add a 
grate of nutmeg, a small piece of 
butter, sugar according to taste. 



33Q 



Special Receipts for the Care of the Sick. 



55. Calves'-Feet Jelly. 

Take two calves' feet and add to 
them oue gallon of water, and boil 
down to one quart. Strain, and, 
when cold, remove all fat. Then 
add the whites of six or eight eggs, 
well beaten (a pint of wine, if desi- 
rable), half a pound of loaf sugar, 
and the juice of four lemons, and 
mix well. Boil for a few minutes, 
constantly stirring. Then strain 
through a flannel bag. 

56. Currant Jelly. 

Boil together equal weights of 
white sugar and the juice of ripe 
currants, until the mixture solidifies 
by cooling, as shown by dropping a 
few drops on a cold plate. Remove 
the scum, and form the jelly in suit- 
able vessels. 

A tablespoonful of this jelly in a 
tumbler of cold water makes a de- 



lightful acid drink, very grateful to 
many invalids. 

57. Irish Moss Blanc-mange. 

Take of 

Irish moss, half an ounce. 

Fresh milk, one pint and a half. 

Boil these down to such a consis- 
tency as to retain a form when cold. 
Remove any sediment by filtering, 
and then add the requisite quantity 
of sugar, with lemon juice or peach 
water, to give an agreeable flavor. 

The moss, before being used, must 
be well washed in cold water, to re- 
move its saltish taste. 

58. Gelatine Blanc-mange. 
Boil one ounce of shred gelatine 
in a quart of milk for ten minutes, 
stirring constantly. Sweeten to the 
taste, flavor with peach water or 
essence of vanilla, and strain into a 
mould. 



PUDDINGS FOR INVALID? 



59. Rice Pudding. 
Boil two ounces of rice in a pint 
of milk, assiduously stirring till it 
thickens. Take it off and let it cool. 
Then well mix in two ounces of 
butter, a quarter of a nutmeg, grated, 
and sugar in moderation, according 
to taste. Pour it into a buttered 
dish and bake. 

60. Bread Pudding. 
Pour over a French roll half a 
pint of boiling milk, cover it close, 
and let it stand till it has soaked up 
the milk. Tie it up tightly in a 
cloth, and let it boil for a quarter of 
an hour. Turn it out on a plate and 
sprinkle a little white sugar over it. 
The addition of burnt sugar or tinc- 
ture of saffron, will give it the estab- 
lished yellow color. 



61. Batter Pudding. 
Take of 

Flour, three teaspoonfuls. 

Milk, one pint. 

Salt, a pinch. 

Powdered ginger. 

Nutmeg. 

Tincture of saffron, each a tea- 
spoonful. 

Boil, 

It will be observed in these three 
receipts eggs are avoided, as when 
baked, or even when boiled, so long 
as it is necessary to boil puddings, 
they are quite insoluble in a weak 
stomach. 

62. Milk for Puddings or Stewed 
Fruit. 
Boil a strip of lemon and two cloves 
in a pint of milk. Mix half a tea- 



Counsels on Giving Food to the Sick. 



331 



spoonful of arrowroot in a little cold 
milk, and add it to the boiling milk. 
Stir it till about the consistency of 
cream. Have ready the yolks of 
three eggs, beaten up well in a little 
milk. Take the hot milk off the 
fire, and as it cools, add the eggs and 
a tablespoonful of 'orange flower water, 
stirring it constantly till quite cool. 
Keep it in a very cool place till 
required for use. 



63. Bice and Apple. 

Boil about three tablespoonfuls of 
rice in a pint and a half of new milk, 
and simmer, stirring it from time to 
time, till the rice is quite tender. 
Have ready some apples, peeled, 
cored, and stewed to a pulp, and 



sweetened with a very little loaf 
sugar. Put the rice round a plate, 
and the apple in the middle, and 
serve with a little of the above prep- 
aration of milk, if liked. 

64. Vermicelli Pudding. 
Take of 

Vermicelli, two ounces. 

Milk, three-quarters of a pint. 

Cream, one-quarter of a pint. 

Butter, one ounce and a half. 

Eggs, two. 

Sugar, one ounce and a half. 

Boil the vermicelli in the milk till 
it is tender, then stir in the remain- 
ing ingredients (omitting the cream 
if that be not obtainable). Butter 
a small tart dish, line with puff paste, 
put in the pudding, and bake. 



We conclude this chapter with the following judicious counsels 
from the pen of Prof. Chambers, of London : " When a patient 
cannot be raised in bed without risk of exhaustion, a crockery or 
glass feeder is a convenience, but the same vessel, or even one of 
the same appearance, should not be used for food and for medicine. 
If the patient's mouth be foul, as in small-pox or putrid fever, it 
should be cleansed when he is fed. The administration of nutri- 
ment should then be so frequent that it is not allowed to become 
again foul. Food should, as a rule, be as near the natural tempera- 
ture of the body as possible. But when the febrile heat is very 
high, or there is much nausea, some of it may be iced, with 
advantage. When life seems passing away under their eyes, the 
friends will often shrink from tormenting (as it seems to them) the 
sick man with food. Let them not despair; many a one has 
recovered after the doctor has taken his leave with a sad shake of 
the head, and without making a fresh appointment. And let them 
also be stimulated by this fact, namely, that the pains of death are 
aggravated, if not mainly caused, by the failure of nutrition. 
Even when apparently insensible, the dying suffer much increased 
distress from want of food, though they cannot express their 
Bufferings." 



CHAPTER XI 

Medical Receipts for the Sick Room. 

Baths and Douches. The hygienic importance of bathing— Rules for 
the use of the bath in health— Division of baths according to their 
warmth — The cold bath and directions for its employment — Warm and 

hot baths, when useful — Medicated water baths — Soap bath — Bran bath 

Starch bath— Oil bath— Alkaline bath— Valerian bath— Gelatine bath- 
Bark bath— Iron bath— Mustard bath— Salt water bath— Liver of sul- 
phur bath— Turpentine bath— Vapor baths: Simple vapor bath— Medi- 
cated vapor bath— Warm air bath— Turkish bath— Russian and Roman 
baths — Fumigations — Shower baths — Douche baths — Sand and mud 
baths— Hip baths or sitz baths— Foot baths— Shallow baths— Cold affu- 
sion— Wet-sheet packing— The dripping sheet— The wet compress— The 
sponge bath— Blisters— Cathartics or Purgatives. Remarks in 
regard to their use— Receipts for Effervescing cream of tartar— Mag- 
nesia and rhubarb — Rhubarb and epsom salts — May apple — Jalap and 
cream of tartar— Calcined magnesia — Seidlitz powders — Purgative mine- 
ral water— Clysters or Injections : A purgative injection— An as- 
tringent injection — Nutritive injections— Cold, mode of applying 

Counter-irritants — Cupping — Disinfectants— Emetics Eyh 

Waters— Fomentations, or Stupes and Steaming — Gargles- 
Heat, mode of applying— Herb and other Medicinal Teas, Re- 
ceipts for — Inhalations Directions for Administering— Leeching 
— Liniments — Lotions or Washes — Ointments or Salves— Pain 
Removers, or Anodynes — Plasters— Poultices: Bread and water 
poultice— Flaxseed meal poultice— Bran poultice— Stimulating poultices 
— Yeast poultice— Molasses poultice— Starch poultice— Charcoal poul- 
tice—Carrot poultice — Alum poultice— Mush poultice — Slippery elm 
poultice — Arrow-root poultice — Onion poultice — Mustard poultice — 
Bread and Milk Poultice— Tonics— Receipts for the hygiene of the person: 
—Tooth powders— Mouth washes— Washes for foul breath— Hair tonics 
— Ointments and washes for dandruff— Lip salves and lotions— Ointments 
and washes for chapped hands— Ointment for fetid feet— Lotions for the 
face— Washes for removing freckles— Ointment for sunburn. 

For convenience of reference we have arranged the various 
classes under which the receipts are grouped in alphabetical order, 
and shall, therefore, commence with 
332 



Baths and Douches. 333 

Baths and Douches. 

Bathing, in its various forms, is an important item, not only in 
hygiene, or for the preservation of health, but in the treatment of 
many ailments, or, for the restoration of health. Baths may be 
divided into simple baths and medicated baths. 

In health, and during the summer particularly, washing the 
whole body in a bath tub, or a running stream, several times a 
week, is of the utmost importance. For this purpose the water 
should not be too cold. Very cold spring water is, therefore, 
unfitted for bathing. If there be no bath in the house a wash tub 
does very well. Or, a bath may be readily constructed of the kind 
shown in the accompanying Figure. It consists of a hammock (a) 
of rubber cloth, extended upon two long poles (6), passed through 
a broad seam on each side of the hammock, and kept asunder by 
the cross pieces (c), which are attached to the cross pieces by thumb 
screws (d). By the flexible tube (/) the water may be drawn off. 
When the poles are fixed as in the figure, and the open end of the 
flexible tube twisted around one of the thumb screws, the bath is 
ready to receive the water. It may be supported upon two chairs, 
or upon the trestles (e.e). 

Fig. 103. 




A Home-made Bath Tub. 
A shower bath is an excellent thing on getting out of bed in the 
morning. A very good make-shift for a regularly constructed 
shower-bath apparatus exists in every house, in the shape of a 
colander. The use of this needs an assistant, however, to pour 
water through it. The accompanying figure shows a hollow tin 
vessel with a perforated bottom. To make a shower bath of it, 
sink it in a bucket of water, put the thumb at the orifice (c) of the 



334 Special Receipts for the Care of the Sick. 



hollow tube (b) and raise the vessel from the bucket of water. 
Fig. 104. The pressure of air keeps the water 

in so long as the thumb is kept on 
the orifice; on removing it, tbe 
water is thrown in a shower on the 
patient, over whose head it is held 
by an attendant. Tbis is especially 
convenient for children. 

After bathing, the skin should 
be rubbed with a hard dry towel, 
or with a flesh-brush, until it is in 
a glow. 

Wben a bath cannot be con- 
veniently taken, it is always possi- 
ble to sponge the chest and arms 
A Home made Shower Bath. with water in the morning on 
rising. This, if made a daily practice, with or without the addition 
of a little vinegar to the water, will be found to be, when cold water 
is employed, an excellent preventive of colds. 

According to their temperature, baths are divided as follows: 




The cold bath 
The cool 
Tbe temperate 
The tepid 
The warm 
The hot 



from 33° to 60° of the ordinary (Fah.) thermometer. 
60° to 75° " " » 

75° to 85° « " " 

85° to 92° •< » " 

92° to 98° " " " 

98° to 112° » « 



The Cold Bath is mainly employed for the purpose of producing 
the powerful reaction which should always follow its use. 

Rules for the Use of the Cold Bath. — 1. Tbe morning is the 
best time. 2. It should never be taken when the body is in a pro- 
fuse sweat. 3. Never immediately after a full meal. 4. The head 
should be immersed first. 5. It should never be prolonged so as 
to cause shivering, blueness of the nails, etc. Five minutes is 
ordinarily a sufficient time. 6. If it cause disagreeable effects, the 
temperature, on another occasion, should be raised, and the time 



The Cold and the Warm Bath. 335 

shortened. 7. So soon as the bath is over, the body must be 
quickly dried, and gentle exercise taken. 

Cautions in Regard to the Use of the Cold Bath. — It should 
never be taken very cold by persons with disease of the heart, nor by 
those suffering from active inflammation of any of the organs of the 
body. In skin diseases it is usually inadmissible, particularly in 
those where a sudden driving in of the eruption may cause internal 
affections. Persons very much debilitated, or those who do not 
possess sufficient powers of reaction, must employ it with great cau- 
tion, if at all. In infancy and old age it is of less benefit than in 
youth and middle life. 

The cold bath is particularly useful where there is a general 
relaxation of the system and a deranged state of the nervous system 
resulting from disease or a too close application to business or study. 
It is a valuable tonic in all cases where no disease of the internal 
organs exists. Like all powerful agents, it must be resorted to with 
judgment, and its effects carefully watched. 

Ailments in which the Cold Bath is Especially Beneficial. — In 
asthma a cold bath in the morning has been found to be of great 
service in many cases. Some prefer sponging the body in a mixture 
of salt and cold water (two or three tablespoonfuls of salt to the 
pint of water). The body should be well rubbed afterwards with 
coarse towels. In persistent whooping cough the cold bath or the 
shower bath has given good results in numerous instances. In St. 
Vitus' dance cold baths and shower baths are often excellent in 
connection with other treatment. Hysterical ailments of all kinds 
are greatly benefited by them. 

The Warm Bath is useful in soothing the nervous system, in 
equalizing the temperature of the body, in modifying the action of 
the skin, in reducing the frequency and force of the heart's action, 
in relaxing the muscular system, in allaying restlessness, in relieving 
pain, and often in inducing quiet sleep. It should be employed 
with caution, if at all, by persons of very gross habits, and by those 
predisposed to apoplexy or to dropsy. On coming out of a warm 
bath, care should be taken to avoid exposure to a current of air and 
so checking the perspiration. 

Ailments in which the Warm and Hot Baths are Useful. — In 



2j6 Special Receipts for the Care of the Sick. 

the fits, or convulsions of children, the warm hath (98° of the ther- 
mometer) is a remedy of the utmost importance, and one which 
should never be overlooked. The trunk of the body should be kept 
in the water during ten or fifteen minutes. The hot bath is of ser- 
vice in mild forms of dysentery. In most diseases of the skin a 
daily employment of tepid or temperate baths is of much benefit. 

Besides plain water baths, medicated baths are of frequent service 
in the treatment of many ailments. We shall, therefore, give a 
number of receipts for their preparation and use. 



MEDICATED WATER BATHS. 



65. Soap Bath. I bonate of soda is indispensable in 
Cut up two pounds of white soap, \ ^^J^PJ^f, the SaltS ° f lim6 

and dissolve in live or six quarts of 
warm water. Add this solution to 
the water of the bath. 

Useful in softening the skin, and 
preparing it for the action of reme- 
dies in many skin affections. 

66. Bran Bath. 

Boil in water, half an ounce of 
bran, for a quarter of an hour. Add 
this to the bath. 

This makes an excellent soothing 
bath. 

67. Starch Bath. 

Mix one pound and a half of grated 
potatoes with live or six quarts of 
water, and gently warm it. Then 
heat to the boiling point, the same 
quantity of water, and add slowly to 
the potato and water mixture in 
stirring. To be added to the bath. 

This" is also an admirable soothing 
bath. 

68. Oil Bath. 

Add a pound of carbonate of soda 
to the warm water of the bath. Dis- 
solve and leave in repose for half an 
hour. Then add half a pint of al- 
mond or cod-liver oil, and mix. 

The preliminary solution of car- 



contained in ordinary water ; without 
this precaution, no thorough mixing 
could be obtained. 

This bath, frequently repeated, in- 
creases the flesn of the sick and con- 
valescent. 

69. Alkaline Bath. 

Add a quarter of a pound of car- 
boii'i/r of soda, or of ordinary baking- 
powder, to the water of the bath. 

This is useful in many skin affec- 
tions. 

70. Valerian Bath. 

Mix one drachrn of bruised valerian 
root with a tumblerful of boiling 
water, and add to the bath. 

This is a useful bath in fits and 
nervous affections. 

71. Gelatine Bath. 

Steep a pound and a half of pow- 
dered gelatine in two quarts of cold 
water, during an hour; complete the 
solution by heating. Add to the 
bath. 

A good soothing bath. 

72. Bark Bath. 
Boil, for half au hour, half a pound 



Medicated Baths. 



337 



of cinchona bark with a pint of 
water, and strain. Add to the water 
of the bath. 
A useful tonic bath. 

73. Iron Bath. 

Add one ounce of the sulphate of 
iron (green vitriol) to the water of 
the bath. 

This bath is recommended for 
scrofulous and rickety children. 

74, Mustard Bath. 

Add two ounces of mustard to the 
water of the bath. 

This makes an effective stimulant 
bath. Often of service in the ex- 
haustion of children ; the child to be 
immersed, all but its head. 

75. Salt- Water Bath. 

Add half a pound of salt to the 
water of the bath, which may be 
eold or warm- according to the sea- 
son. 

Very useful in scrofula and general 
debility. 

76. Liver of Sulphur Bath. 

Add two ounces of liver of sulphur 
to the water of the bath. 

Frequently of great benefit in St. 
Vitus' Dance. Also of much service 
in itch. 

77. Turpentine Bath. 
Take of 

Baking soda, two pounds. 

Turpentine, a tumblerful. 

Oil of rosemary, a tablespoonful. 

Add to the water of the bath. 

This bath calms the pulse, softens 
the skin, and renders the respiration 



78. Simple Vapor Bath. 

A vapor bath may readily be given 
by placing the unclothed patient on 
a cane-bottomed chair, with a large 
blanket fastened round his neck, 
reaching to the ground. Under the 
chair put a spirit lamp or a hot 
brick and a dish containing wa- 
ter. So soon as the water boils it 
surrounds the body with an atmos- 
phere of vapor. Or, the patient 
may remain in bed, and the vapor 

29 



be introduced under the covers by 
means of a rubber tube fastened 
over the spout of an ordinary tea 
kettle in which water is kept boiling. 

79. Medicated Vapor Bath. 

The water to be evaporated may 
be readily medieated by throwing in 
dried herbs, such as rosemary, thyme, 
lavender flowers, or any others which 
it may be desirable to employ. 

In many chest and throat affec- 
tions watery vapor, either simple or 
medicated, may be diffused, with 
advantage, through the air of the 
sick room, by means of a small open 
boiler placed over the fire, a gas, or 
a spirit lamp. 

80. Warm Air Bath. 
This consists in exposing, for a 
short time, the naked body to the 
air of a common chamber which has 
been made very warm. It acts pow- 
erfully upon the skin, and induces 
perspiration very quickly. 

81. Turkish Baths. 

This bath is essentially a hot air 
bath, alternated with shampooing 
and cold douches. It can only, of 
course, be taken in large cities, 
where establishments for the pur- 
pose exist. The same remark ap- 
plies to Russian and Roman baths. 

These baths are dangerous when 
any heart disease exists, and should 
never be takeu by the sick or en- 
feebled, except upon competent medi- 
cal advice. 

82. Fumigations. 
These are vapors or gases obtained 
by heating various substances, for 
the purpose of masking unpleasant 
odors in the sick room, for modify- 
ing the air in it, or for producing an 
effect upon portions of the body with 
which they are brought in contact. 
They are frequently very improperly 
employed for concealing odors the 
cause of which should be removed 
by cleanliness and ventilation. They 
are generally made by burning cam- 
phor, sugar, juniper berries or ben- 
zoin, or by heating vinegar in the 
room. 



338 Special Receipts for the Care of the Sick. 



83. Shower Bath. 

The shower bath resembles, in its 
effects, the cold bath, but the shock it 
gives, with its thousand little blows, 
is more violent, particularly if the 
water be very cold, its quantity great, 
and its fall considerable. Its uses are 
the same as those of the cold bath. 

84. Douche Bath. 

This consists of a stream of water 
let fall or thrown, by means of a tube 
or otherwise, upon some portion of 
the body. Its power varies with the 
temperature of the water, the volume 
of the stream, and the force with 
which it is projected. A stream of 
an inch diameter, falling five or ten 
feet, is sufficient, borne for half a 
minute. It must be used with care. 

In fainting, the cold douche, sud- 
denly applied to the spine, some- 
times suddenly restores conscious- 
ness. Stiff joints, after injuries or 
rheumatic attacks, are often bene- 
fited by cold douches of water upon 
them. A thin stream of cold water 
directed, for a few moments, from 
an elevation of two or three feet, 
upon the top of the head, is fre- 
queutly useful in fits or convulsions 
of full-blooded children. 

85. Sand and Mud Baths. 
Warm sand baths are sometimes 
useful in the treatment of rheumatic 
joint affections. They are made by 
neaping up warm sand about the 
limb. At some mineral springs, and 



at the seaside, patients affected with 
gout, rheumatism, or general dropsy, 
are treated by being buried to the 
neck in sand, mud, or gravel, satu- 
rated with the warm mineral water. 

86. Hip Baths or Sitz Baths. 
These consist simply of any conve- 
nient vessel, containing warm water, 
in which the patient can sit, so that 
the hips will be completely immersed. 
They are of use in gravel and kidney 
diseases. 

87. Foot Baths. 
These are very useful in drawing 
away the blood from the brain, lungs 
or other organs which are congested, 
or the seat of pain. They also, if 
their temperature be not above 100°, 
excite perspiration and persuade 
sleep. Salt or mustard may be 
added to the water, which should 
rise as high as the calves of the legs. 
The foot bath may be prolonged for 
fifteen or thirty minutes, a blanket 
being thrown over the limbs, so as 
to enclose, also, the foot tub. 

88. Shallow Baths. 
A shallow bath is taken by sitting 
the patient in a bath tub, five or six 
feet long, and pouring in sufficient 
water to rise eight or ten inches. At 
the same time the body and limbs 
should be well rubbed by an attend- 
ant, and water poured over the head. 
The water should be cold and the 
I stay in it very short. It is useful in 
I many cases of nervous irritability. 



COLD AFFUSION. 



Manner of applying cold affusion. The patient, being unclothed, 
is to have from three to five gallons of water, at 50° F. or 60° F., 
in the winter, and 60° or 70° in the summer, poured over him. 
Simple water, or vinegar and water, or salt and water may be used. 
The safest time for the application during fever is, when the exacer- 
bation is at its height, or immediately after its declination has 



Blisters. 



339 



begun. From six to nine o'clock in the evening is the hour usually 
chosen. 

Cautions in the use of cold affusion. 1. It should never be 
employed when there is any sense of chilliness, although the ther- 
mometer in the armpit indicate a high degree of heat. 2. It should 
never be employed in the cold stage of fever, nor when the heat, 
measured by the thermometer in the armpit, is less than, or equal 
to, the natural heat (96° F.), even though the patient is not chilly. 

3. It should never be employed when the body is in a profuse per- 
spiration ; nor, in fever complicated with any visceral inflammation. 

4. The patient should always immerse his hands for a few moments 
in the water, before it is applied to any other part of the body ; this 
prevents the shock from being too violent. 

The earlier in the disease it is resorted to the better the effects 
of cold affusion ; but in the more advanced stages it will be found 
to moderate the symptoms. It is useful in sleeplessness and in 
fevers. 



90. Wet-Sheet Packing. 

A sheet, dipped in cold or warm 
water, and well wrung out, is wrapped 
around the patient, and covered with 
three or more blankets. The patient 
should lie upon his. side, thus wrapped 
up, for half an hour or an hour. 
Perspiration, ordinarily not very 
profuse, is produced, and a sedative 
effect upon the system obtained. 

91. The Dripping Sheet. 

A dripping wet sheet is suddenly 
thrown over the patient while stand- 
ing, the. skin briskly rubbed by the 
hands of an assistant, a dry sheet 
thrown on in the place of the wet 
one, the rubbing briskly kept up, 



and the entire operation finished in 
five minutes. 

92. The Wet Compress. 

A piece of flannel or muslin, wrung 
out in cold water, is put around the 
seat of pain, and covered over by -a 
piece of oiled silk or muslin. 

93. The Sponge Bath. 
Sponging the body once or twice a 

day in fevers, with cold water, alone 
or mixed with vinegar, is very grate- 
ful and refreshing to the hot and 
restless patient, and may be employed 
with safety, if care be taken not to 
expose the moist skin to a current of 
air. 



BLISTERS. 



A blister is best made by spreading the ointment of Spanish flies 
over an adhesive plaster, so as to leave a margin for attaching it to 



34-0 Special Receipts for the Care of the Sick. 

the skin. It should be removed so soon as it causes decided pain, 
or so soon as the skin is well reddened, and the operation completed 
by means of a soft, soothing poultice. An extremely thin piece of 
muslin or paper, moistened with spirits of turpentine, inserted 
between the blister and the skin, will prevent that annoying irrita- 
tion of the bladder which sometimes follow the use of a blister. 
In dressing a blister the bladders should be pierced with a large 
needle, and not cut, unless it is desired to keep up an open sore. 



CATHARTICS OR PURGATIVES. 

Cathartics or purgatives are medicines which loosen the bowels. 
Those which act violently are called drastics, those which act 
mildly, aperients or laxatives. 

Remarks in regard to their use. The habitual employment of 
purgatives is a practice productive of great injury, causing dyspepsia 
and many other troubles of the stomach and bowels. Purgatives 
should not be given so that their operation will interfere with the 
regular hours of rest. They should aot be taken immediately after 
a full meal. The action of every purgative is followed by a greater 
or less amount of costiveness. This is especially true of rhubarb, 
least so of castor oil. In cases of great debility cathartics should 
be avoided. 



94. Effervescing Cream of Tartar. 
Take of 

Cream of tartar, 

Carbonate of soda, each three 
drachms. 

Water, a tumblerful. 

Put the whole into a stone jug or 
bottle, and attach the cork firmly. 
To be taken in the morning, before 
eating. 



95. Magnesia and Rhubarb. 
Take of 
Magnesia, one ounce. 

Rhubarb, two drachms and a half, produce a laxative effect, 
Powdered ginger, two scruples. 



Mix and divide into eight powders. 
Take one or two in the evening, a' 
bed-time, to obtain a laxative effect 
in the morning. 



96. Rhubarb and Epsom Salts. 
Take of 

Powdered rhubarb, one drachm. 

Epsom salts, one ounce. 

Spirit of peppermint, two drops. 

Water, a tumblerful. 

One or two tablespoonfuls wiU 



Clysters and Injections. 



341 



97. May Apple, or Mandrake. 
Take of 
Powdered resin of May apple 

(Podopliyllin), one grain. 
Powdered hyoscyamus leaves, eight 

grains. 
Powdered ginger, twelve grains, 
Mix and divide into four powders. 
One or two at bedtime in torpor of 
the liver and bilious disorders. A 
much better and safer pill than blue 
mass or other mercurials, so fre- 
quently employed indiscriminately 
in these cases. 

98. Jalap and Cream of Tartar. 
Take of 

Powdered jalap, one drachm. 

Cream of tartar, six drachms. 

Mix and divide into six powders. 
Dose, one, in molasses. 

99. Calcined Magnesia. 

Take of 

Husbands' or Ellis' magnesia, 

thirty grains, 

And dissolve it in a little milk or 

water for one dose. This is an ex- 



cellent cooling laxative. Its opera- 
tion is promoted by the drinking of 
lemonade. 

100. Seidlitz Powders. 
These are to be obtained of any 
druggist. Two powders are given 
together, a white and a blue one; 
each of which is to be dissolved, 
separately, in a tumbler one-third 
full of water, and the two solutions 
then mixed and drank while foam- 
ing, in the morning, before break- 
fast. This is a very popular, gentle 
laxative, and well borne by the 
stomach when other medicines of 
the kind disagree. 

101. Purgative Mineral Water. 

Take from a bottle of the solution 
of the citrate of magnesia, to be had 
of any druggist, a teacupful every 
two hours, until it operates. For a 
child five years old, a wineglassful 
is the proper dose. This prepara- 
tion, which tastes like lemonade, is 
one of the most agreeable of laxa- 
tives. 



CLYSTERS OR INJECTIONS. 

Clysters or injections are solutions thrown into the lower bowel, 
in order to act as purgatives, as astringents to check diarrhoea, or 
stop bleeding, or as nutrients to nourish the patient in those ex- 
hausted conditions when food cannot be given by the mouth. 



102. A Purgative Injection. 

Take of 

Epsom salts, one ounce. 

Sweet oil, two tablespoonfuls. 

Starch water, one pint. 

To be given when a purgative is 
required. 

Common salt and molasses also 
make an excellent purgative injec- 
tion; a tablespoonful of each in a 
pint of water, with or without the 
addition of a little soap. 

29* 



103. An Astringent Injection. 
Take of 
Subnitrate of bismuth, twenty 

grains. 
Tincture of catechu, a teaspoonful. 
Milk, a wineglassful. 

For one injection, to be repeated 
in twelve hours. Useful in checking 
the purging of consumption, fevers, 
etc. 



342 



Special Receipts for the Care of the Sick. 



104. Nutritive Injections. | give food by the mouth, as it is at 

Life can be prolonged, and even, | onve rejected by the stomach. Ntt- 
in many cases, preserved, bv the tritive injections are made of strong 
persistent use of nutritive injections beef tea, milk, raw eggs, cod-liver 
when, in ailments like ulceration ml, and, even in extreme cases, ot di- 
of the stomach, it is impossible to , ll "ed brandy. 



COLD, MODE OF APPLYING. 

Cold has been employed in the treatment of disease from the 
earliest times. It is applied in various ways, by cold baths, by 
streams of cold water, by cold moist sponges and cloths, by bladders 
filled with ice, and by the evaporation of ether. 



105. Cold Application. 
Take of 

Nitre, half an ounce. 

Sal ammoniac, two drachms. 

Vinegar, three tablespoonfuls. 

Water, a pint. 

Mix. This solution, applied, by 
means of Bponges or cloths, to the 
head, and elsewhere, where intense 
cold is desired, produces a more 
powerful effect than cold water or 
pounded ice. 

106. Cold without Moisture. 

When it is desired to apply a 
freezing mixture to a small portion 
of the skin, it may be readily done 
by ] Hitting a mixture of ice and 
salt in a bladder, or a tumbler, or a 



lamp glass covered with a piece of 
bladder. 

107. Hydropathic Belts. 
A hydropathic belt consists of a 
bandage, five or six inches wide and 
long enough to pass two or three 
times around the body It is dipped 
into cold water, carefully wrung out, 
wound around the trunk, and cov- 
ered by a wider and longer dry band. 
About every hour, or as often as it 
- dry, it is to be changed A 
bandage may he applied in the same 
manner upon various parts of the 
body, and particularly over the joints 
attacked by rheumatism. An erup- 
tion of the' skin is usually produced 
by this application, which is fre- 
quently of service. 



COUXTER-IRRITAXTS. 



Counter-irritants are applications intended to irritate the parts to 
which they are applied, and by exciting artificial congestion or 
inflammation, to modify disease existing in a distant part. How 
this curative power is exerted, it is difficult to say. Professor 
Stille remarks: "It is a familiar fact that the body Is an assem- 
blage of organs, which are constantly exerting a reciprocal influence 



Counter-irritants. 



343 



upon one another, so that all are more or less involved in the 
derangements of each. Examples of sympathy between remote 
parts, and exerted through the organ of the mind, are innumerable. 
Emotions of pleasure or shame suffuse the face with blushes ; while 
fear and the depressing passions blanch the cheeks, chill the 
extremities, and bedew the skin with a cold sweat. So, emotions 
of pity or tenderness make the tears flow ; the odor or sight of 
agreeable food, or even the thought of it, makes the mouth water; 
while disgusting objects turn the stomach, and alarming ones 
suspend digestion or destroy the appetite. Obstinate constipation 
has been overcome by causing the patient to stand upon a wet 
marble pavement; consumption has often supervened upon the 
suppression of an issue or other habitual discharge ; and still more 
frequently, apoplexy and other internal congestions have followed 
the same causes. The translation of gout and rheumatism to the 
brain, heart, stomach, etc., when suppressed in the extremities, is 
familiar to every practitioner. The coryzas, and sore throats, and 
pulmonary catarrhs, diarrhoeas, and other affections which arise 
from merely getting the feet wet, are matters of daily experience, 
whose reality cannot be denied nor explained away. They are 
neither more nor less intelligible than the effects of counter-irrita- 
tion, and both must be accepted because they are facts." 

Shakspeare, whose wonderful acquaintance with the actions of 
the body has furnished us with more than one illustration, speaks, 
in "Romeo and Juliet," of the principle of counter-irritants, as 
follows : — 

" Tut, man, one fire burns out another's burning, 
One pain is lessened by another's anguish. . . . 
Take thou some new infection to thy eye, 
And the rank poison of the old will die." 

Counter-irritation is affected by the application of various sub- 
stances which redden or blister the skin 



108. Croton-Oil Liniment. 

Take of 

Croton oil, thirty drops. 
Sweet oil, two tablespoonfuls. 
Mix. Produces, when rubbed on, 

redness and eruption of the skin. 

A useful application to the chest in 

beginning consumption. 



109. Iodine Paint. 
Take of 

Tincture of iodine, 

Alcohol, equal parts. 

To be applied with a camel's-hair 
brush. Useful in many cases of 
persistent pains in the joints and 
limbs (See, also, Blisters and Cups). 



344 Special Receipts for the Care of the Sick. 

CUPPING. 

Physicians employ two sorts of cups, known as wet cups and 
dry cups. The former are for the purpose of extracting blood, the 
latter for counter-irritation by reddening the skin. A dry cup can 
be readily applied by any one. All that is necessary is a tumbler 
.r wine-glass, and a little piece of cotton or paper, which is to be 
wet with spirits of wine, set on fire, thrown into the glass, which 
should then at once be firmly pressed down over the skin, when the 
tire will be quickly extinguished (without causing any pain), and 
the skin drawn up forcibly into the glass. The same object may be 
accomplished by holding the tumbler over a light until the air within 
is well heated, and then applying it quickly and closely to the skin 

Cupping is of benefit in rheumatic ailments, and in many affec- 
tions of the chest and of the large joints. 



DISINFECTANTS. 

Disinfectants are substances which possess the power of destroying 
poisons capable of producing disease, and of removing disagreeable 
odors and gases by decomposing both them and the bodies from 
which they proceed. 

The principal disinfectants are carbolic acid, coal tar, creosote, 
charcoal, chlorine, permanganate of potash, quicklime, sulphate of 
iron (copperas or green vitriol), sulphur, and fresh earth. 



110. Carbolic Acid as a Disinfectant. 
Take of 

Impure carbolic acid, one ounce. 

Water, one gallon. 

Mix. Sprinkle over the floors of 
privies, about sinks, etc. 

HI. Charcoal as a Disinfectant. 

Powder some -wood charcoal and 
expose it, in open pans, in the place 
to be disinfected. It has the advan- 
tage over lime preparations, of being 
without odor. 



112. Chlorine as a Disinfectant. 
Chlorine water, to be obtained 

from any druggist, is a useful ageut 
for correcting stenches, and, diluted 
with water, for washing foul sores. 

113. Permanganate of Potash. 
Take of 

Permanganate of potash, a tea- 
spoonful. 

Water, a quart. 

Expose, in saucers, in the sick 
room. Useful for musty closets and 
foul cellars. It has do odor itself. 



Emetics. 



345 



114. Green Vitriol. 
Sulphate of iron, commonly called 
green vitriol, or copperas, in powder, 
alone, or mixed with lime, is an ex- 
cellent disinfectant for privy-wells, 
slaughter-houses, ditches, etc. 

115. Fresh Earth. 
Fine dry earth, sprinkled over 
offensive matters, is an admirable 
disinfectant. A knowledge of this 
fact has led to the construction of 
earth closets. A box of dust from the 
road, and a tin cup, kept at the side 
of the closet or chamber vessel, so 
that the earth may be thrown imme- 
diately upon the dejection, will serve 
as a complete deodorizer, and answer 
the purpose almost as well as the 



elaborately-constructed patent earth 
closets now in the market. 

116. Sulphur. 
Take of 

Milk of sulphur, a teaspoonful. 

Water, one pint. 

Mix. Sprinkle over clothes to be 
disinfected, and iron with a hot flat- 
iron. 

The fumes of burning sulphur 
may be employed for disinfecting 
out-houses, closets, carriages, etc. 



117. To Quickly Remove a Bad Smell. 
An unpleasant odor may be quickly 
removed from the sick room by burn- 
ing in it dried lavender or cascarilla 
bark, with the window open. 



EMETICS. 

Emetics are medicines which cause yc-miting. They are used to 
remove from the stomach poisons or crude indigestible matters, to 
dislodge things lodged in the throat or air-passages, and to excite 
the action of the skin and of the liver. They are not, except, of 
course, in cases of poisoning, to be given when there is disease of 
the heart, great irritability of the stomach, or much general debil- 
ity. They are well borne by children, and of much service in many 
of the ailments of infancy and childhood. Their action is promoted 
by drinking plentifully of warm water, and by tickling the throat 
with a feather. When the vomiting produced is too violent or too 
long continued, it may be checked by a few drops of laudanum, or 
by applying a mustard plaster over the pit of the stomach. 



118. Mustard Emetic. 

Take a teas230onful of mustard in 
a teacupful of warm water, every ten 
minutes, until vomiting is produced. 

This is an efficient, quick, and 
safe emetic. 

119. Alum Emetic. 

Take a teaspoonful of powdered 
alum in a little honey, syrup, or 
molasses, every fifteen minutes, until 
vomiting is produced. 



120. Common Salt Emetic. 

Add one or two teaspoonfuls of 

salt to a teacupful of warm water. 

Take every ten or fifteen minutes, 

till vomiting is produced. 



121. Salt and Mustard Emetic. 

Mix a teaspoonful each of salt 
and mustard in a teacupful of warm 
water. Repeat every ten minutes, 
until free vomiting is brought on. 



}4.6 Special Receipts for the Care of the Sick. 

EYE-WASHES OR WATERS. 

Eye-waters, or collyria, as they are called by physicians, are 
solutions applied directly to the eye or eyelids. 



122. Alum Eye-wash. 
Take of 

Alum, one grain. 

Pure water, two tablespoonfuls. 

Mix. A useful wash, night and 
morning, for inflamed eyes. 

123. Brandy Eye-wash. 
A teaspoonful of brandy to two 
tablespoonfuls of water makes a 
serviceable eye-water when a stimu- 
lant is wanted. 



124. Arnica Eye-wash. 
Take of 

Tincture of arnica, five drops. 

Pure water, two tablespoonfuls. 

Mix. Often of benefit in weak or 
sore eyes. 



125. Tea Eye-wash. 
Ordinary tea, when cold, makes a 
valuable eye-water in many cases. 



FOMENTATIONS, OR STUPES AND STEAMING. 



Fomentation is the application of warmth and moisture to the 
surface of the body by means of a flannel or soft cloth. Steaming 
consists in exposing a part to the vapors arising from a piece of 
flannel wrung out in boiling water ; it is often employed in affec- 
tions of the eyes. 



126. An Ordinary Fomentation. 

Immerse a piece of flannel in boil- 
ing'water, remove it and put it in a 
wringer made by attaching stout 
toweling to two rods. The wringer 
is twisted around the flannel very 
strongly, till as much as possible of 
the water is pressed away. The 
wringer is useful, as the flannel is 
too hot, when first removed from the 
boiling water, to be grasped by the 
hand. When wrung as dry as possi- 
ble, fomentations prepared in this 
way may be applied very hot, with- 
out fear of scalding or blistering the 
skin. The flannel, when applied to 
the part, should be covered with a 
piece of oiled silk or rubber cloth, 
and changed before it becomes cold. 
On the removal of the fomentation 



the skin should be at once gently 
dried and covered with a piece of 
dry flannel. 

If the precaution of covering the 
fomentation with oiled silk, muslin, 
or paper, or a rubber cloth, be neg- 
lected, the warm, comforting flannels 
will be converted, in a few minutes, 
into cold, clammy, wet ones, disa- 
greeable and hurtful to the patient. 



127. Turpentine Fomentation. 

Steep a piece of lint or linen in 
oil of turpentine, place it over the 
part, and immediately apply over it 
flannel, heated as hot as it can be 
borne. 

This is, frequently, more effectual 
than a mustard plaster. 



Heat, Mode of Applying. 



347 



128. Another Turpentine Fomenta- 
tion. 

Sprinkle the flannel, wrung out of 
hot water in the manner described, 
with a tablespoonful of turpentine. 

This will act as a counter-irritant, 
rapidly reddening the skin and re- 
lieving pain in many cases. 



129. Opium Fomentation. 

of turpentine, employ 



laudanum, as directed in the preced- 
ing receipt. Used to relieve pain. 

1^0. Mustard Fomentation. 

Add a quarter of a pound of mus- 
tard to a pint of boiling water. 
Wring the flannel cloths out in this 
solution, in the manner above di- 
rected. 

This fomentation quickly reddens 
the skin, and is frequently useful in 
allaying pain. 



GAKGLES. 

Gargles, to be of benefit, must be frequently repeated, and their 
use persevered in. 



131. Gargle of Brandy. 
A mixture of equal parts of brandy 
and water makes a useful gargle in 
some cases of sore throat. 

132. Gargle of Alum. 

Take of 

Alum, two teaspoonfuls. 

Water, a tumblerful. 

Mix. Used to remove offensive 
breath depending upon inflamed 
throat. 

133. Gargle of Lime-Water. 

Pour upon a quarter of a pound 

of fresh unslackened lime two quarts 

of hot water. After standing several 

hours carefully decant the clear 



liquid, without shaking up the lime. 
This is a valuable gargle in diph- 
theria and croup, 

134. Gargle of Chlorate of Potash. 

Take of 

Chlorate of potash, a teaspoonful. 

Water, a tumblerful. 

Mix. An excellent gargle for 
ordinary sore throat, 

135. Gargle of Sage and Linseed. 

Take of 

Sage, two ounces. 

Linseed, one ounce. 

Boiling water, one pint. 

Mix. To be used cold in the early 
stages of inflamed throat. 



HEAT, MODE OF APPLYING. 



Moist heat is applied by means of fomentations and poultices, 
which see. Dry heat may be applied in various ways. Flannel, 
highly heated in an oven, or before the fire, may be employed, but 



348 Special Receipts for the Care of the Sick. 

it cools quickly. Hot sand, though heavy, and, therefore, for 
many purposes improper, retains its heat for a long time. It 
should be heated over the fire in an iron pan, and put in a warm 
linen hag of the proper shape for the object in view. Chamomile 
flowers are lighter than sand, but more quickly lose their warmth. 
They are to be heated, and placed in a linen bag, in the same 
manner as the sand. Hot salt, in a bag, is a ready method of 
applying heat in many cases, as, for instance, to the back of the 
neck, at night, to relieve headache. A thin piece of flat-tile, 
when it can be procured, can often be used with advantage. It is 
lighter than sand, and, when heated in an oven, and wrapped in a 
flannel, retains its warmth for a considerable time. A heated 
dinner-plate, or a hot brick, wrapped in flannel, may sometimes be 
employed, as may also bottles of hot water, well corked. 



HERB, AND OTHER MEDICINAL TEAS. 



Of any of the following 
two or three hours. 



teas the dose is a wineglassful every 



136. Pipsissewa Tea. 
Take of 

Pipsissewa, bruised, one ounce. 

Water, one pint. 

Boil for fifteen minutes, strain, and 
add sufficient water, through the 
strainer, to make the tea measure a 
pint. 

Useful to act upon the skin, pro- 
duce perspiration, etc. 

137. TJva Ursi (Bearberry) Tea. 
Take of 

Bearberry leaves, one ounce. 

Water, one pint. 

Boil for fifteen minutes, strain, and 
add sufficient water, through the 
strainer, to make the tea measure a 
pint. 

Useful to act upon the kidneys. 



138. Bittersweet Tea. 
Take of 
Bittersweet, bruised, one ounce. 
Water, one pint. 

Boil for fifteen minutes, strain, and 
I add sufficient water, through the 
strainer, to make the tea measure a 
]jint. 

Useful to act upon the skin and 
kidneys. 



139. Logwood Tea. 
Take of 

Logwood, rasped, one ounce. 

Water, one quart. 

Boil down to a pint, and strain. 

Useful in diarrhuea and dysen- 
tery. 



Herb, and Other Medicinal Teas. 



349 



140. White Oak Bark Tea. 

Take of 

White oak, bruised, one ounce. 

Water, one pint. 

Boil for half an hour, strain, and 
add sufficient water through the 
strainer, to make the tea measure a 
pint. 

Useful in persistent diarrhoea. 

141. Yellow Cinchona Tea. 

Take of 

Yellow cinchona, bruised, one 
ounce. 

Water, one pint. 

Boil for fifteen minutes, strain, and 
add sufficient water to make the tea 
measure a pint. 

142. Bed Cinchona Tea. 

Take of 

Bed Cinchona, bruised, one ounce. 

Water, one pint. 

Boil for fifteen minutes, strain, and 
add sufficient water, through the 
strainer, to make the tea measure a 
pint. 

Useful as a tonic. 

143. Dogwood Tea. 

Take of 

Dogwood, bruised, one ounce. 

Water, one pint. 

Boil for fifteen minutes, strain, and 
add sufficient water, through the 
strainer, to make the tea measure a 
pint. 

Useful to give appetite and strength 
after sickness. Also, to break an at- 
tack of fever and ague. 

144. SenekaTea. 
Take of 

Seneka, bruised, one ounce. 

Water, one pint. 

Boil for fifteen minutes, strain, and 
add sufficient water through the 
strainer to make the tea measure a 
pint. 

Useful as an expectorant. 

145. Iceland Moss Tea 
Take of 

Iceland moss, half an ounce. 

Water, one pint. 

Boil for fifteen minutes, strain, 
with squeezing, and add- sufficient 
water through the strainer to make 
the tea measure a pint. 

Useful for coughs and colds. 

30 



148. Black Elder Tea. 
Take of 

Inner bark of black elder, one 
ounce. 

Water, one quart. 

Boil down to one pint. A wine- 
glassful, or more, is a useful purga- 
tive in dropsy. 

147. Juniper Tea. 

Take of 

Juniper berries, bruised, a table- 
spoonful. 

Boiling water, one pint. 

Pour the boiling water on the 
bruised berries, and, when cool, 
drink the whole in the course of the 
day. 

Useful in dropsical affections. 

148. Blackberry Boot Tea. 

Take of 

Small blackberry roots, a large 
tablespoonful. 

Water, one pint and a half. 

Boil down to a pint. Instead of 
the small roots the bark of the 
larger roots may be employed. The 
dose is a tablespoonful, four or five 
times a day, in diarrhoea and dys- 
entery. 

149. Goose Grass Tea. 

Take of 

Goose grass, a handful. 

Water, a quart. 

Boil for twenty minutes. Dose, a 
tumblerful, thrice daily, in skin dis- 
eases and in gravel. 

150. White Walnut Tea. 
Take of 

White walnut bark, one ounce. 

Water, a quart. 

Boil for half an hour. Dose, a 
wineglassfuL as a mild purgative. 

151. Burdock Tea. 

Take of 

Burdock root, freshly bruised, a 
handful. 

Water, three pints. 

Boil down to a quart. A pint to 
be taken, in divided doses, during the 
day. 

Useful in persistent skin affections 
and scrofulous ailments. It acts de- 
cidedly upon the skin, slightly upon 
the bowels. 



35o 



Special Receipts for the Care of the Sick. 



162. Calamus Tea. 
Take of 

Calamus root, one ounce. 

Boiling water, one pint. 

Pour the water on the calamus, 
and, when cool, give in doses of a 
wineglassful for the relief of colicky 
pains in the bowels. Especially use- 
ful for children. 

153. Dandelion Tea. 
Take of 

Dried dandelion root, sliced and 
bruised, one ounce. 

Water, one pint. 

Boil for ten minutes in a covered 
vessel, then strain, and pour as much 
water over the contents of the 
strainer as will make the strained 
product measure a pint. Dose, a 
wineglassful several times a day in 
biliousness and dropsy. 

154. Wormseed Tea. 
Take of 

Fresh wormseed leaves, one ounce. 

Milk, one pint. 

Boil with a little orange peel. 
Dose, a wineglassful, morning and 
evening, for the expulsion of worms 
from the bowels. 



155. Seneka and Liquorice Tea. 
Take of 

Seneka snakeroot, 

Liquorice rout, each a andful. 

"Water, two quarts. 

Boil for half an hour and strain. 
Dose, a wineglassful several times a 
day in obstinate coughs and colds. 

156. Flaxseed Tea. 

Take three tablespoonfuls of flax- 
seed, put in a small linen bag, sus- 
pend in a quart of water, and boil 
for twenty minutes. Flavor with a 
little lemon. 

A soothing drink in ailments of 
the chest and bowels. 

For a tea of flaxseed and liquorice 
see receipt No. 5, among the dietetic 
preparations on page 323. 

157. Parsley Tea. 
Take of 

Parsley root, one ounce. 

Boiling water, one pint. 

Pour the boiling water over the 
parsley root, and strain. A teacup- 
ful alone, or with a teaspoonful of 
sweet spirits of nitre, every tour 
hours, is an excellent remedy in 
dropsy. 



IXHALATIOXS. 



By means of inhalation, remedies are made to enter, in the form 
of vapor, the air passages, and so come immediately in contact with 
the affected surfaces they are designed to treat. A funnel, turned 
over a bowl of hot water, medicated as required, makes a simple 
inhaler, the patient drawing the vapor through the neck of the 
funnel. An ordinary teapot may be readily made to serve the 
same purpose. An excellent inhaler may be easily made in any 
house, from a large and wide-mouthed bottle. Fit a cork into it 
accurately, bore two holes in the cork, through which pass two 
glass tubes, one straight, extending to the bottom nearly, the other 



Inhalations, 



351 



curved, extending only a slight distance below the cork, and not far 

enough to touch the liquid for inhalation, to be placed in the bottle. 

The accompanying illustration shows, at a glance, 

how to make such an inhaler. The end of the 

bent portion of the tube is the mouth-piece. The 

solution for inhalation is to be placed in the 

inhaler, filling it only about one-third full, and 

the inhaler then set in a vessel of hot water, to 

generate the vapor. When ready for use, take 

the extremity of the bent tube in the mouth, 

and draw the vapor into the lungs. Various 

substances are used for inhalation. The simplest 

of all is the steam of hot water, which is very 

beneficial in many throat and chest ailments. 

Another simple but effective inhalation in 

many cases, is obtained by pouring vinegar into 

boiling water. 




158. Balsam of Tolu Inhalation. 
Take of 

Balsam of tolu, one ounce. 
Boiling water, one pint. 
Put in a bowl, cover with an in- 
verted funnel, and inhale the vapor. 

159. Cubebs and Carbolic Acid 

Inhalation. 
Take of 

Tincture of cubebs, a tablespoon- 
ful. 

Fluid carbolic acid, twenty drops. 

Mix. Add to half a tumblerful of 
water in the inhaling bottle, and use 
every three or four hours until tired . 
Very efficient in relieving- the dry 
cough and pain of consumptive 
patients. 

160. Inhalation of Tar. 
Take of 
Tar, one pint. 

Solution of potassa (to be obtained 

of the druggist), two tablespoon- 

fuls. 

Mix these two ingredients, and boil 

for a few minutes in the open air, in 

order to disengage any impurities. 



Then keep thera simmering in the 
sick room, in an iron vessel, over a 
spirit lump or other fire. In this 
way, not only the chamber, but the 
entire house is quickly pervaded by 
an agreeable vapor, which, although 
it may at first excite an inclination 
to cough, both in healthy and sick 
persons, very soon, in most cases, 
allays this symptom, and with it a 
great portion of a consumptive 
patient's distress. 



161, Carbolic Acid Inhalation. 
Take of 

Fluid carbolic acid, ten drops. 

Boiling water, a tumblerful. 

Place in inhaling bottle, and use 
three or four times a day, in catarrh 
and offensive secretions from the air 
tubes. 

162. Creosote Inhalation. 
Take of 

Creosote, thirty drops. 
Boiling water, a tumblerful. 
Put in inhaler, and use several 
times a day, in chronic catarrh. 



352 Special Receipts for the Care of ike Sick, 



LEECHING. 

Leeching is a mode of removing blood from a part, and is much 
employed in the treatment of many affections. 

Leeches are best kept in rain water, in a stone or glass jar, in a 
damp cellar or other cool place. It is better not to change the 
water oftener than once a week. 

How to get the leeches to fix. Clear the skin carefully of all 
perspiration, and, if they do not readily take hold, moisten it with 
a little sweetened water or milk, or sweet beer. If a number are 
to be applied on one spot, put them in a tumbler, or small wine- 
glass, or pill-box, and turn it down on the part. When they are to 
be spread over a large surface, they have to be applied one by one, 
with the hand, over which a towel or handkerchief may be fastened. 
When applied, the leeches should be let alone, and allowed to drop 
off of their own accord. When detached, the part should be 
powdered with a little dry starch, and covered with a soft cloth. 

If it be desired to continue the bleeding after the leeches come 
off, it can readily be done by sponging away the clotted blood and 
applying a warm bread and milk poultice, to be changed every half 
hour, or by covering the part with hot, moist flannels. To check 
the bleeding, a piece of lint wet with a mixture of vinegar and 
water, or a strong solution of alum in water, may be bound over 
the part. If this should fail, and the loss of blood become excess- 
ive, send to the drug store for a little of Monsell's solution of iron, 
and apply it on a piece of lint. 

Children bear leeches badly. Leeches, if employed at all, should 
be used with great caution, only one or two at a time in infantile 
ailments. Adults will readily bear fifteen to twenty leeches at a 
time. A good foreign leech will take about a tablespoonful of 
blood ; an American leech only about a teaspoonf'ul. 

Leeches must never be put to the eyelids, and rarely upon the 
face, as they may leave scars. 



Receipts for Liniments. 



353 



LINIMENTS. 

Liniments are used for the double purpose of causing the removal 
of swellings and for reddening the skin, and so act as counter-irri- 
tants. They are applied by rubbing, either with the bare hand or 
with the hand covered by a piece of flannel, oiled silk or muslin, or 
a piece of bladder. 



163. Camphor liniment. 
Take of 
Camphor, one ounce 
Olive oil, four ounces. 
Rub up the camphor in the oil. 

164. Hartshorne and Oil. 
Take one part of hartshorne to two 
parts of oil; mix. 
Useful for stiff neck and lumbago. 

165. Opodeldoc. 
Take of 

Hard white soap, three ounces. 

Camphor, one ounce. 

Put them in a bottle, and add a 
tumblerful of spirits of wine, or 
brandy, or any other spirit, and as 
much water. Shake the bottle from 
day to day, till the soap and camphor 
are dissolved, when the liniment is 
ready for use. 

A mixture of two tablespoonfuls of 
this liniment with a teaspoonful of 
laudanum, is very valuable to lull 
violent rheumatic pain. 

166. Mustard Liniment 
Is. for stimulating the surface, e 
of the best, as it is very manageable, 
and may be made to act either very 
slightly, or so severely as to take the 
skin off, according to the quantity 
used and the time the rubbing is 
kept up. The best guide as to the 
quantity required is the feelings of 
the person rubbed. At first, there is 
a pleasant sensation of heat, then a 
little pricking, and next a positive 
smarting; when this is produced, 
leave off, for if the rubbing be con- 
tinued, it will soon flay the skin, and, 
as a consequence, prevents its being 
rubbed again for three or four days. 

30* 



An ounce of fresh flour of mustard 
put into a bottle with a pint of spirits 
of turpentine, and shaken daily fox- 
two or three days, make this lini- 
ment. The mustard will settle to 
the bottom, and the clear fluid should 
be then poured off. Do not leave the 
mustard in and shake the bottle up 
before using; if so, it will give the 
skin a coating of mustard, and render 
the application unnecessarily severe. 
It is excellent for lumbago and chil- 
blains. 

Sometimes it is necessary to keep 
up irritation on the skin for a length 
of time without disturbing the con- 
stitution, which some irritants will 
do. The best application for this 
purpose is — 

167. Croton Oil, 
Of which ten or a dozen drops are 
to be rubbed in lightly with the fin- 
gers, guarded with a piece of oiled 
silk, for two or three nights. Gene- 
rally, on the second day the surface 
is red and pufl'y, and on the third 
day a large crop of little blisters, 
about the size of hempseed, cover the 
skin. When these appear, the rub- 
bing must be stopped. In the course 
of a few hours, the fluid in the blis- 
ters changes to matter, and these 
pustules begin to tingle and itch 
furiously. As soon as this happens, 
prick each with the point of a needle, 
and press out the matter with a 
handkerchief. In the course of a 
week the skin has been completely 
reproduced, and then the croton oil 
may be used again ; but it does not 
blister quite so quickly as when first 
applied. The croton may be used 
for months, and is a most excellent 
mild irritant. 



354 



Special Receipts for the Care of the Sick. 



168. Lime Liniment. 

Take of 
Lime water, 

Flaxseed oil, each a tumblerful 
Mix them. 



169. Chloroform Liniment. 
Take of 

Pure chloroform, a wineglassful. 

Olive oil, two wineglassfuls. 

Mix them. 

A useful liniment in many painful 
rheumatic and neuralgic affections. 



170. Lead Ointment. 
Take of 
Solution of sugar of lead, two 

ounces. 
Olive oil, two wineglassfuls. 
Mix them. 

171. Turpentine Liniment. 
Take of 

Rosin cerate (to be had of the 
druggist), three-quarters of a 
pound. 
Oil of turpentine, a tumblerful. 
Add the oil to the cerate, pre- 
viously melted, and mix them. 



LOTIONS OR WASHES. 

Washes are employed either for soothing and cooling inflamed 
parts, for stimulating sluggish sores to heal, or for drying and 
absorbing discharges. 

In applying a cooling lotion or wash, a single piece of linen 
should be wet with it and laid on the part, which should not be 
wrapped up nor covered with the bed-clothes. So soon as the cloth 
dries it should be again dipped in the lotion, or wet by squeezing a 
spongeful of the wash over it. 

A stimulating lotion is applied by dipping lint or rag into it, 
putting it on the sore and confining it by a bandage. 

Lint, for use for this and so many other purposes, in dressing 
wounds and sores, is made by unraveling old linen, soft from use 
and washing. It may be prepared by scraping tightly-stretched 
linen with a sharp knife. A "patent lint" is sold at all the drug- 
stores, in rolls or sheets, which is more compact than loose lint, one 
side being fleecy and the other smooth. Charpie is an excellent 
sort of lint, much employed. It is made as follows : Cut a piece 
of lint into small pieces, a few inches square, and completely un- 
ravel it, thread by thread. The coarser kind may be made of old 
tablecloths. Old linen is much better than new for making 
charpie. 



Lotions or Washes. 



355 



Drying lotions are applied, by means of lint or rag, to cracked 
skin, and to scalds, burns, and sores wbich weep or discbarge very 
freely. 



172. Cold Water Wash 
Is as good a wash as any, to pro- 
duce evaporation, if care be taken 
to have the wet linen well exposed 
to the air; and it has the further 
advantage of being almost always at 
hand, 

173. Spirit Wash. 

Half a quarter of a pint of spirits 
of wine, or a quarter of a pint of 
brandy, or any other good spirit, 
added to a pint of water, make this 
wash. 

174. Vinegar Wash 
Is made by mixing one-fourth of 
vinegar to three-fourths of water. 

To a pint of either of the former 
washes half a tablespoonful of lauda- 
num may be added, if the pain 
suffered be very severe. 

175. Lead Wash, or Goulard- Water 

or White Wash, 
As it is often called, for common 
purposes, may be made by dissolving 
one drachm of sugar of lead in a 
pint of soft water. Some persons 
are very fond of using this wash, 
With the addition of spirits of wine, 
as an evaporant. 

176. Lime Water Wash, 
A very simple application; is one 
of the best, and very easily made. 
Take half a pound of unslaked lime, 
and three-quarters of a pint of water. 
Put the lime into an earthen pot, 
and pour a little of the water upon 
it, and as the lime slakes pour the 
water on by little and little, and 
stir up with a stick. The water 
must be added very slowly, other- 
wise the lime will fly about in all 
directions, and the great heat sud- 
denly produced will crack or break 
the vessel which contains it. After 
three or four hours, when the slaked 
lime has sunk to the bottom, the 
clear fluid may be poured off, and 
put in a stoppled bottle, away from 
the light. 



177. Oxide of Zinc Wash 
Is made by putting four drachms of 
oxide of zinc into a pint of lime water, 
which does not, however, dissolve, 
but merely suspends it. It is, there- 
fore, always necessary to shake the 
bottle well up, so that the linen may 
entangle the proper quantity of the 
oxide. 

178. Sal Ammoniac Wash. 
Take of 

Sal ammoniac, one drachm. 

Water, a tumblerful. 

Mix, with or without the addition 
of a teaspoonful of laudanum. 

Useful for painful, sluggish sores. 

179. A Cooling Sal Ammoniac 
Wash. 
Take of 

Sal ammoniac, one drachm. 

Nitre, two drachms. 

Vinegar, two tablespoonfuls. 

Water, a tumblerful. 

Mix, apply by means of one layer 
only of linen, without any covering, 
to heated inflamed surfaces. 

180. Another Sal Ammoniac Wash. 
Take of 
Sal ammoniac, 

Nitre, 

Common salt, each two teaspoon- 

fuls. 
Water, one pint. 
Apply as i " 



181. Chlorate of Potash Wash. 
Take of 

Chlorate of potash, a teaspoonful. 

Water, a tumblerful. 

A useful application to bad sores, 
and for chapped or cracked hands. 

182. Borax Wash. 

Take of 
Borax, a teaspoonful. 
Glycerine, a tablespoonful. 
Water, a tumblerful. 
Mix. An agreeable soothing lotion. 



356 Special Receipts for the Care of the Sick. 

184. Arnica Lotion. 



183. An Absorbent Wash 
Take of 
Oxide of zinc, two drachms. 
Water, a tumblerful. 

Mix. 



Take of 

Tincture of arnica, a tablespoon- 
ful. 

Water, a tumblerful. 

Mix. A useful lotion for sprains, 
bruises and burns. 



OINTMENTS OR SALVES. 



Ointments or salves are usually prepared by rubbing of a medi- 
cine with lard. They should not be kept on hand too long, as they 
become rancid and unfit for use. 



185. Sulphur Ointment. 
Take of 

Flowers of sulphur, half a pound. 

Lard, one pound. 

Oil of bergamot, two teaspoonfuls. 

Mix up together. A curative 
ointment for itch. 

186. Carbonate of Ammonia Oint- 
ment. 
Take of 
Carbonate of ammonia, half a 

drachm. 
Lard, half an ounce. 
Mix. A useful application to 
sluggish, scrofulous, sores. 

187. Common Ointment. 
Take of 

Yellow wax, one ounce. 
Olive oil, four ounces. 
Lard, one ounce. 
Mix. A soothing salve. 



188. Tannin Ointment. 
Take of 

Tannin, one drachm. 

Lard, one ounce. 

Mix. An excellent astringent 
salve. 

189. Camphor Ointment. 
Take of 

Camphor, ten grains. 
Spirits of wine, a few drops. 
Lard, one ounce. 
Mix. Useful in some skin dis- 
eases. 

190. Oxide of Zinc Ointment. 
Take of 

Oxide of zinc, one drachm. 

Lard, two ounces. 

Mix. Useful for chapped skin 
and sores. 



PAIN REMOVERS, OR ANODYNES. 



The boldest doubter, he who, in rude health, is a most defiant 
and sarcastic skeptic of the power of medicine, is forced, by the 



Pain Removers, or Anodynes. 



357 



terror and victory of pain, to confess the beneficence of the sub- 
stances given us by a merciful Creator for the subduing and the 
destroying of that pain. 

" Pain is perfect misery, the worst 
Of evils, and, excessive, overturns 
All patience." 

The most powerful means for relieving pain, such as opium by 
the mouth, morphia injected under the skin, and chloroform by 
inhalation, are such potent agents for evil, as well as good, that 
their use can only be trusted to those trained to employ them. 
But there are other means which can be handled, with greater or 
less success, by non-medical persons. Many of them we have 
mentioned in speaking of painful ailments, but we group, in this 
place, a number of receipts for the relief of pain, which are of no 
little value, and which can be employed, with the exercise of ordi- 
nary care and judgment, without the risk of doing harm. 

191. Quinine Powders. 
Take of quinine, twenty grains, 
and divide it into eight powders. 
One of them twice a day is an excel- 
lent remedy in many forms of neu- 
ralgia (particularly in that occurring 
in persons living in districts where 
chills and fever prevail) and sick 
headache. 

192. Sal Ammoniac. 

Take of sal ammoniac, twenty 
grains, for one dose, in half a tum- 
bler of water. Repeat the dose at 
the end of every hour, until four 
doses are taken, when, if no relief is 
had, the medicine is not appropriate 
to the case, and it is needless to con- 
tinue. If it aiford relief, as it does 
frequently, in an almost magical 
manner, in neuralgia of the face, 
and other parts, it should be taken 
three times a day, for a week or two, 
after the attack. 

193. Camphor. 

Haifa teaspoonful of the spirits of 
camphor in water, is an excellent 
remedy for, the pains of colic and 
diarrhoea. 

Painful joints are also relieved by 



the rubbing in over them of spirits 
of caunphor, by itself or mixed with 
a little laudanum. 

194. Chloral. 

Take of 

Chloral, two drachms. 

Sweetened water, half a tumbler- 
ful. 

Take a tablespoonful for a dose. 
Useful to procure ease and sleep in 
many ailments, particularly rheu- 
matic pains and pains arising from 
burns. 

195. Coffee. 

Squeeze the juice of a lemon in a 
small cup of strong black coffee. 
This will often afford immediate 
relief in neuralgic headache. 

Tea ordinarily increases neuralgic 
pain, and ought not to be used by 
persons affected with it. 

196. Iodide of Potassium. 

Take of 

Iodide of potassium, one drachm. 

Sweetened water half a tumbler- 
ful. 

Mix. Take a tablespoonful three 
times a day, in pains of the joints 
and bones that are worse at night. 



353 



Special Receipts for the Care of the Sick. 



197. External Applications. 

Warm and hot baths are admirable 
remedies for pain. So, also, are 
poultices and hot fomentations, for 
which receipts are given under their 
heads in this chapter. 

198. Hygienic Means. 
Whatever improves the general 
health, saves and relieves paia. 
Pure air is, therefore, an anodyne. 

" Ye, who amid this feverish world 

would wear 
A body free from pain, of cares a 

mind, 
Fly the rank city, shun its turbid 

air." 



Light rooms; warm clothing; 
regulated gymnastic exercise, such 
as described" in the first chapter of 
this book, page 37 ; out-door recrea- 
tion ; proper amount of sleep; the 
avoidance of fatigue of body and 
mind ; and of intemperance in alco- 
hol and tobacco, and in everything 
else which impairs the nervous force ; 
together with change of air and cli- 
mate as restoratives, are all means 
by which pain may be escaped or its 
edge blunted. 

Many forms of neuralgia are re- 
lieved by change of air, as well as 
various constitutional disorders caus- 
ing pain. Sea air is particularly use- 
i ful in numerous instances 



POULTICES. 



" Poultices are blessings or curses, as they are well or ill made," 
was a saying of the celebrated Dr. Abernethy. They should be 
spread thickly, as a general rule, otherwise they dry quickly, and 
irritate the part they are intended to soothe. 

All poultices should be covered over by apiece of oiled silk, 
muslin, or paper, to retain the heat and moisture. 



199. Bread and Water Poultice. 

Scald out a basin, for, in order to 
make a good poultice perfectly, boil- 
ing water is necessary; then, having 
put in some hot water, throw in 
coarsely-crumbled bread, and cover 
it with a plate. When the bread has 
soaked up as much water as it will 
imbibe, drain off the remaining 
water, and there will be left a light 
pulp. Spread it, a third of an inch 
thick, on folded linen, and apply it 
when of the temperature of a warm 
bath. 

Or, carefully pare away the hard, 
brown crust from a slice around the 
loaf of stale bread, dip it into hot 
water, lift it out at once, and apply 
immediately, if not too hot. 



200. Flaxseed Meal Poultice. 

The celebrated Dr. Abernethy gave 
the following directions for making 
this poultice : — 

" Get some linseed powder, not the 
common stuff full of grit and sand. 
Scald out a basin ; pour in some per- 
fectly boiling water ; throw in the 
powder, stir it round with a stick, 
till well incorporated ; add a little 
more water and a little more meal ; 
stir again, and when it is about two- 
thirds the consistence you wish it to 
be, beat it up with the blade of a 
knife till all the lumps are removed. 
If properly made, it is so well 
worked together, that you might 
throw it up to the ceiling, and it 
would come down azaiu without 



Poultices. 



359 



falling to pieces ; it is, in fact, like a 
pan-cake. Then take it out, lay it 
on a piece of soft linen, spread it the 
fourth of an inch thick, and as wide 
as will cover the whole inflamed 
part ; put a bit of hog's lard in the 
centre of it, and when it begins to 
melt, draw the edge of the knife 
lightly over and grease the surface 
of the poultice. When made in this 
way, oh ! it is beautifully smooth ; 
it is delightfully soft ; it is warm and 
comfortable to the feelings of the 
patient." 

201. The Bran Poultice 

Is a sort of "entire," or half-and 
half, partly poaltice, partly fomen- 
tation, and is a very good applica- 
tion for setting up and keeping up 
perspiration on a part; but it re- 
quires to be often changed, for it 
very quickly becomes sour, and then 
has not the most agreeable smell. 
It merely consists of bran moistened, 
but not made wet, with hot water ; 
and enough of it should be put into 
a flannel bag, sufficiently large to 
cover the part, to fill it about one- 
third ; if more bran be put in the 
bag becomes unpleasantly heavy. 
It must then be held before the fire, 
and the bran turned about again and 
again, till it is thoroughly heated. 
Thus warmed, it must be quickly 
applied, and the bran should be 
gently spread, so as to cover the 
whole extent of the bag. 



202. Stimulating Poultices 
Are required for two purposes: 
either to hasten the separation of a 
dead part or slough, or, as it is 
called in common language, " a set- 
fast," or "core;" or to irritate the 
skin where it is inconvenient to ap- 
ply a blister, or for the purpose of 
rendering the operation of a blister 
more speedy. For the first of these 
objects, yeast, stale beer-grounds, or 
molasses, is used for the second, 
mustard. 

203. Yeast Poultice 
Is made by mixing a pound of flour, 
or linseed-meal, or oat-meal, with 
half a pint of yeast or beer-grounds. 



The mixture is to be heated in a pot, 
carefully stirred, to prevent burning, 
and, when sufficiently warm, must 
be spread on linen, like any other 
poultice. 

204. Molasses Poultice 

May be made according to the same 
proportions, heated and applied in 
the same way. 

205. Starch Poultice. 

Add a little cold water to the 
starch, and blend the two into a 
pap; then add sufficient boiling 
water to make a poultice of the re- 
quired consistence, which must be 
spread on linen. 

Useful in skin eruptions attended 
with much heat and pain, and, in 
general, when a soothing application 
is required. 

206. Charcoal Poultice. 

The charcoal may either be mixed 
with the ingredients of the poultice 
or sprinkled over the part and cov- 
ered with a simple poultice, or the 
following receipt may be used : 
Take of 

Wood charcoal, in powder, a table- 
spoonful. 

Bread, three or four slices. 

Flaxseed-meal, three tablespoon- 
fuls. 

Boiling water, one tumblerful. 

Mix. A useful application to offen- 
sive wounds and sores. 

207. Carrot Poultice. 

Boil the carrots till they become 
quite soft, mash them with a fork, 
and spread the pulp on linen, in the 
ordinary way. 

A turnip poultice may be made in 
the same manner. 

208. Alum Poultice. 

Composed of the whites x>f two 
eggs and a teaspoonful of powdered 
alum. An excellent astringent. 

209. Mush Poultice. 

Stir Indian-meal, in small quanti- 
ties, into water kept boiling in a 
pan, until the whole has acquired 
the proper degree of thickness. 



360 Special Receipts for the Care of the Sick. 



210. Slippery Elm Poultice. 

Made by moistening, with hot 
water, the inner bark of slippery 
elm, ground into a fine powder. 



211. Arrowroot Poultice. 

Add enough boiling water to 
arrowroot, previously mixed with 
cold water into a smooth paste, as 
will make it of the required thick- 
ness for spreading. A pleasant 
soothing poultice. 



212 



Onion Poultice, 
some partially roasted 



Mash 
onions, and spread them upon folds 
of muslin. Applied to the chest, 
useful in the croup and catarrh of 
children; applied to the arms and 
lees, useful to prevent the fits of 
children. 



213. Mustard Poultice. 

For a mustard poultice, a sufficient 
quantity of powdered mustard should 
be taken to make a thin paste the 
required size. This should be mixed 
with boiling water, with a small 
quantity of vinegar added, if a very 
strong poultice is required, and 
spread on brown paper, with a piece 
of thin muslin over it. 

A mustard poultice should gener- 
ally be kept on from ten to twenty 
minutes, but some skins will bear it 
much longer than others. If the 
skin is very irritable afterwards, a 
little flour should be sprinkled over 
it. This will remove the burning 
sensation. 

214. Bread and Milk Poultice. 

Upon the crumbs of stale wheat 
bread, in a basin, pour boiling milk, 
stirring with the back of a spoon 
until the mixture has the thickness 
of mush. Spread and apply. 



TOXICS. 



Tonic medicines are those which give strength to the system. 
They act slowly, and must he persevered in to obtain their full 
effects. Excellent results are frequently obtained by changing from 
one to another, when the first tried fails, or has ceased to do good. 



215. Quinine in Powder. 
Take of 

Quinine, two scruples. 

Divide into twenty powders. Take 
one three times a day, well covered 
in a little scraped apple. The apple 
disguises, completely, the bitter taste 
of the medicine. 

This is an admirable tonic in ner- 
vous and other forms of debility, and 
in loss of appetite. 



216. Quinine in Solution 
Take of 

Quinine, eight grains. 

Syrup of gum arabic, 

Ammonia water, each two table- 
spoonfuls. 

Mix. As the quinine is not dis- 
solved, but merely suspended in this 
solution, the bottle must be well 
shaken before giving a dose. 

This is a useful preparation for 



Receipts for the Hygiene of the Person. 



361 



children, the proper dose for them 
being a teaspoonful, containing one- 
half a grain of quinine. 

The gum masks, somewhat, the 
bitter taste of the medicine. Used 
for the same purposes as the preced- 
ing receipt. 

217. Iron Powder. 

Take of 

Reduced iron, two scruples. 

White sugar, in powder, two tea- 
spoonfuls. 

Mix, and divide into twenty pow- 
ders. Dose, one powder, in molasses, 
syrup, or preserves, three times a 
day. 

Reduced iron, which is a tasteless 
powder of an iron gray color, may be 
obtained from any druggist, and is 
one of the very best preparations of 
iron which can be taken by pale, 
thin-blooded people. 

In using this, as well as the other 
preparations of iron, it is necessary 
to persevere for several months, to 
reap the fullest results. 

218. Potassio-tartrate of Iron. 
Take of 
Potassio-tartrate of iron, one 
drachm. 



Divide into twelve powders. Take 
one, in syrup or preserves, three 
times a day. An admirable tonic in 
dyspepsia, and loss of appetite, and 
debility. It has the advantage over 
many other preparations of iron, of 
not constipating the bowels, and of 
being rapidly digested. 

Half an ounce of the potassio-tar- 
trate of iron, added to a pint of 
sherry after solution, may be used 
instead of the powders, in tablespoon- 
ful doses. 

The best time for taking this, and 
other preparations of iron, is with 
the meals, and not on an empty 
stomach. The juice in the stomach 
during digestion readily dissolves 
the iron, which, if taken while fast- 
ing, may cause pain and uneasiness. 



219. Columbo and Ginger. 
Take of 

Bruised columbo, one ounce. 

Bruised ginger, a quarter of an 
ounce. 

Boiling water, one pint. 

Mix and strain. 

A wineglassful four or five times a 
day is a useful tonic in persistent 
diarrhcea. 



RECEIPTS FOR THE HYGIENE OF THE PERSON. 



Under this head we group a variety of useful receipts for the 
care of the hair, the skin, and the teeth. They are all harmless, 
as well as efficient, which, too frequently, is not the case with the 
many perilous compounds widely advertised, and sold as tooth 
powders, hair tonics, mouth and skin washes, and lip salves, under 
high-sounding names. Any druggist can put them up, and at a 
less price than is asked for the dangerous secret preparations they 
are designed to replace. 
3] 



362 Special Receipts for the Care of the Sick. 



TOOTH POWDERS. 



220. 

Take of 

Powdered camphor, 

Powdered orris root, each two 
drachms. 

Precipitated chalk, half an ounce. 

Mix thoroughly. The chalk em- 
ployed should be the " precipitated," 
and not the " prepared " chalk of the 
druggist. 

Another excellent tooth powder is 
the following : — 



Take of 

Freshly -prepared willow charcoal, 

or, 
Freshly-prepared areca-nut char- 
coal, one ounce. 
Keep in a tightly-corked bottle. 
Another powder, especially valu- 
able when the teeth have been 
stained by taking iron : — 



Take of 

Tannic acid, quarter of an ounce. 

Sugar of milk, two ounces. 

Red lake, half a drachm. 

Oil of teaberry, or cloves, a few 
drops. 

Mix with care. 

A tooth paste, of use occasionally, 
is the following : — 



Take of 

Finely -powdered white, dried Cas- 
tile soap, 

Sepia, in powder, each a quarter 
of an ounce. 

Mix, to the thickness of a paste, 
with fresh, clarified honey, and per- 
fume with a few drops of teaberry. 

As the " sepia " wears the enamel 
if often used, this powder is for occa- 
sional employment only. 

The following tooth powder is of 
benefit when the gums are sore and 
spongy :— 



Take of 

Powdered myrrh, quarter of an 
ounce. 

Powdered borax, half an ounce. 

Precipitated chalk, one ounce. 

Powdered orris root, quarter of an 
ounce. 

Mix. 

The following tooth powder is 
excellent when the saliva is acrid 
and the breath sour : — 

225. 

Take of 

Bicarbo ate of soda, 

Powdered talc, each half an ounce. 

Oil of anise, a few drops. 



Improper tooth powders are powdered pumice stone, which 
rapidly wears off the enamel, the protecting cover of the teeth 
(pumice stone is a frequent ingredient in secret tooth powders), 
cigar ashes, cream of tartar, or any other acid. 



MOUTH WASHES. 

These are useful when the gums are tender, or the breath 
offensive, or the teeth rapidly decaying. 

226. Camphor Mouth Wash. 
Take of 
Spirits of camphor, half a teaspoon- 

ful. 
Milk-warm water, a wineglassful. 
To be used several times a day, 
and at bedtime. 



227. Honey Mouth Wash. 
Take of 

Honey of rose, half a teaspoonful. 
Milk-warm water, a wineglassful. 
Mix, and use as above directed. 



Receipts for the Hygiene of the Person. 



363 



228. Myrrh and Cinchona Mouth 

Wash. 
Take of 

Tincture of myrrh, 

Compound tincture of cinchona, 

each half a teaspoonful. 
Milk-warm water, a wineglassf'ul. 
Mix, and use as above directed. 

229. Brandy Mouth Wash. 
Take of 
Pure French brandy, a teaspoon- 
ful, 
Milk-warm water, a wineglassful. 
Mix, and use as above directed. 

230. Permanganate of Potash 
Mouth Wash. 
Take of 

Permanganate of potash, four 
grains. 

Rose water, four fluid ounces. 

Oil of peppermint, a few drops. 

This is an excellent mouth wash 
for foul breath, caused by bad teeth 
or disordered secretions of the 
mouth. It slightly stains the teeth, 
but does them no injury; on the 
contrary, being an excellent pre- 
servative, and a valuable remedy for 
preventing and curing toothache. 



The discoloration may be easily 
taken off by a tooth brush or sponge. 

231. Chlorate of Potash Mouth 

Wash. 
Take of 
Chlorate of potash, two or three 

teaspoonfuls. 
Water a tumblerful. 
Oil of teaberry, a few drops. 
To be used several times a day. 



When offensive breath comes from 
a foul stomach, twenty grains of 
bisulphite of soda, in half a tumbler 
of water, with a little essence of 
peppermint, twice a day, is an ex- 
cellent remedy. Or, three grains of 
chlorinated lime, known also as chlo- 
ride of lime, in a wineglassful of 
water, several times a day, may be 
taken. Charcoal, internally, is also 
of use in such cases. 



For masking the scent of onions, 
and other disagreeable acquired 
odors, freshly-roasted coffee grains 
are useful, or a small portion of 
Canada snakeroot, chewed. 



HAIR TONICS 



234. 

Take of 

Pure glycerine, three drachms. 

Lime water, four ounces. 

To be applied to the scalp, night 
and morning, with a soft tooth 
brush, after the head has been 
cleaned by gently washing with 
Castile or sulphur soap and warm 
water. 

This is ah excellent treatment to 
commence with for slight scurfiness 
of the head, and falling of the hair, 
and baldness. 

After several weeks' use the pre- 
paration may be changed to the fol- 
lowing : 



Take of 

Tincture of cantharides, half an 
ounce. 

Pure glycerine, three drachms. 

Lime water, four ounces. 

To be rubbed into the skin, briskly, 
twice a day. 

The following hair tonic is also 
often of service for scurf and com- 
mencing baldness : — 

236. 

Take of 
Pock salt, as much as will dissolve. 
Pure glycerine, a tablespoonful. 
Flour of sulphur, a teaspoonful. 
Old whiskey, a tumblerful. 
Mix.' 



364 Special Receipts for the Care of the Sick. 



237. Bark Hair Tonic 
Take of 
Red cinchona tea (see receipt No. 

142), a tumblerful. 
Brandy, a wineglassful. 
Pure glycerine, a tablespoonful. 
Mix. Apply, night and morning, 
for scurf and falling of the hair. 



238. Ammonia Hair Tonic. 
Take of 

Stronger water of ammonia, 

Castor oil, each one ounce. 

Old brandy, two ounces. 

Rose water, six ounces. 

Mix. This mixture must not be 
employed oftener than every other 
day. 



239. Ointment for Dandruff. 
Take of 

Powdered borax, twenty grains. 

Lead water (diluted solution of 
subacetate of lead), two drachms. 

Fresh lard, one ounce. 

Attar of roses, a few drops. 

Mix. To be rubbed on the scaly 
patches on the scalp every morning, 
after the skin has been cleaned by 
soap and water. 

Or, the same ingredients may be 
used in a wash as follows : — 

240. Wash for Dandruff. 

Take of 

Powdered borax, twenty grains. 
Lead water, two drachms. 
Pain water, half a tumblerful. 
Pure glycerine, a tablespoonful. 
Mix. Use once or twice a day. 



LIP SALVES, LOTIONS, ETC. 



241. Lip Salve. 
Take of 

Oxide of zinc, thirty grains. 

Spermaceti ointment, half an 
ounce. 

Attar of roses, one drop. 

Mix. To be applied, night and 
morning, for irritated and cracked 
lips, after bathing the parts with the 
following : — 

242. Lotion for the Lips. 
Take of 

Alum, a teaspoonful. 

Water, a tumblerful. 

Instead of alum, borax may be 
often used, with advantage. 

243. Solution for Fever-Blisters. 
Take of 

Carbolic acid, ten drops. 

Pure glycerine, a teaspoonful. 

Attar of roses, two drops. 

Cautiously touch the sore part 
with this preparation several times a 
day. Or, wet the little blisters with 
a solution of permanganate of potash 
(one grain to a tablespoonful of 
water) and dust with fine starch or 
French chalk. 



244. Lotions for the Hands. 

Add a tablespoonful of pure gly- 
cerine to a pint of water. This, 
well rubbed in, but not wiped off, 
will soften and whiten the hands, 
and protect them from the air. 

Another simple, but effectual, 
wash for this purpose is the follow- 
ing:— 

245. 

Take of 

Horse-chestnuts, a sufficient quan- 
tity. 

Peel them, and dry thoroughly in 
the oven. Then pound or grind into 
a fine powder, and add a tablespoon- 
ful of the powder to the water in the 
hand-basin each time the hands are 
rinsed. 

For chapped hands nothing is bet- 
ter than pure glycerine, well rubbed 
in, several times a day. A little 
tincture of benzoin may be added, 
with benefit, to the glycerine. 



Take of 

Sal ammoniac, a teaspoonful. 
Aromatic vinegar, a tablespoonfuL 
Warm soft water, a quart. 



Receipts for the Hygiene of the Person. 



365 



This solution, used for soaking the 
hands, during ten or fifteen minutes, 
morning and evening, is recom- 
mended for improving the skin, 
preventing redness, and destroying 
warts. 

It is also of service for clammy 
moisture of the hands. 

Clammy hands are also benefited 
by adding half a teaspoonful of 
alum to the wash-water. 

247. Ointment for Fetid Feet. 
Take of 
Crystallized carbolic acid, five 

grains. 
Ointment of oxide of zinc, one 
ounce. 



Mix. Apply, morning and even- 
ing, after washing the feet in cold 
water, with which a few teaspoon- 
fuls of alum have been mixed. In 
such cases, the wearing of a thin 
sole of felt inside the shoe, which 
should be removed several times a 
week, wet in a solution of permanga- 
nate of potash (twenty grains to the 
ounce of water), dried, and rein- 
serted, is of benefit. The stockings 
should be of wool, and changed 
once a day, and the same pair of 
shoes should not be worn on two 
consecutive days. 



WASHES FOR THE FACE. 



Take of 

Powdered borax, half an ounce. 

Pure glycerine, one ounce. 

Camphor water, one quart. 

Mix. Wet the face with this, 
morning and evening, allow it to 
remain for several minutes, and wash 
in rain water. An excellent lotion 
to prevent chapped skin, to remove 
sunburn, and cleanse the pores of 
the skin. 

249. 

Take of 

Fresh lemon juice, a wineglassful. 

Rain water, one pint. 

Attar of roses, a few drops. 

Mix, and put in a well-corked 
bottle. Wash the face and hands 
with this several times a day (letting 
it stay on for several minutes before 
drying with the towel). This prepa- 
ration is highly recommended by the 
celebrated Dr. Wilson, of London, 
for clearing the complexion of 



250. 

Take of 

Juice of cucumber, pressed from 
the fruit, a sufficient quantity. 

Boil it over a quick fire, cool 
rapidly, and bottle. Apply a table- 

31* 



spoonful, diluted with two table- 
spoonfuls of water, night and morn- 
ing. This preparation is much em- 
ployed in France for clearing the 
complexion. 

In some parts of England the 
following wash is much employed 
for removing sunburn and whitening 
the skin : — 

251. 
Take of 

Fresh horseradish root, one ounce. 

Cold buttermilk, one pint. 

Put aside for four hours. 

Or, 

252. 
Take of 

The juice of horseradish, one part. 

Cider vinegar, two parts. 

Mix. Has the same uses as the 
above receipt, and is also recom- 
mended for removing freckles. 

253. 

Take of 

Benzoin, two ounces. 

Pure alcohol, one pint. 

Mix. A tablespoonful of this, 
added to a tumbler of water, turns 
it white, and makes a most agree- 
able wash for clearing the com- 
plexion. 



366 Receipts for the Hygiene of the Person. 



254. Ointment for Sunburn. 
Take of 

Spermaceti, 

Oil of almond, each two ounces. 

Honey, one teaspoonful. 

Attar of roses (or any scent), a few 
drops. 

Melt the spermaceti in a pipkin, 
then add the oil of almonds, and, 
when they are thoroughly mixed, 



stir in the honey. Take the pipkin 
off the fire, and "stir constantly, until 
it is cool, adding the scent. 

Apply at night, after washing the 
skin, and allow it to remain until 
morning. It relieves the irritated 
burning skin, and lessens the red- 
ness. Cold, fresh cream smeared 
over the affected parts sometimes 
does good. 



As lunar caustic and tincture of iodine are medicines in common 
use, and stain the skin and body linen, the following directions for 
remo ving these stains will be found useful : 



255. To Remove Stains of Lunar 
Caustic (Nitrate of Silver) from 
the Skin. 

"Wash the parts discolored by hand- 
ling a stick or solution of lunar 
caustic in a solution of iodide of 
potassium in water. The washing 
will turn the discolorations from 
brown to dead white. Then wash 
in a solution of spirits of hartshorn. 

256. To Eemove Stains of Lunar 

Caustic from Linen. 
The best way to remove stains of 
nitrate of silver from linen is to 
moisten the stain with a few drops 
of a solution of one drachm of cyan- 
ide of potassium in a wineglassful of 
water, to which a few drops of tinc- 
ture of iodine has been added imme- 
ately before using the solution. The 
linen should then be well rinsed in 



clear water. This plan removes even 
the oldest stains of nitrate of silver, 
provided the operation be carried on 
in a moderately lighted room. The 
cyanide of potassium may be ob- 
tained of the druggist, but is a vio- 
lent poison, which should be kept 
and handled with great care. 

257. Another Way of Removing Ni- 
trate of Silver Stains from the 
Fingers. 

Moisten the part with tincture of 
iodine; immediately apply spirits of 
hartshorn, and wash off. 

258. To Remove Iodine Stains from 

Linen. 
Dissolve two drachms of the hypo- 
sulphite of soda in half a tumbler of 
water, and soak the stains in the 
solution, then wash in water. 




CONCLUSION. 

Charity to the Poor and Sick. 

In closing this review of the afflictions to which, the human hody 
is exposed, and this enumeration of the resources which science and 
experience have at command to alleviate them, were it not well to 
reflect how many there are, within reach of every one of us, who 
stand in great need of such alleviations, and who have no means to 
procure them? By the expenditure of hut a little time, and a 
small outlay, it is in our power to soothe many an aching brain and 
fevered body. " The poor always ye have with you," said One 
whose words do not fail, and there is no benevolence more practical, 
more immediately a duty, than to aid the poor who are sick. 

Poor and sick ! How much misery in those three monosyllables, 
which the poet might have called ' The saddest words of tongue or 
pen." 

Hospitals and almshouses do not supply the need, and it is but 
an excuse for heartlessness and selfishness to say so. Very many 
cases are not suited for admission to them, and they never equal the 
requirements of a community. In no sense do they relieve the 
individual of the command which has been laid upon him, to " visit 
the sick in their affliction." 

Nor is the spirit of that command complied with when we merely 
supply the actual wants of the invalid, furnish him food and fuel, 
clothing and medicines. The charity that stops here is cold indeed, 
and the thoughtfulness which extends no further, takes little note of 
the deeper needs of the human heart. Our civilization has created 
for us necessities none the less real because they are artificial. As a 
gifted woman once remarked, " Poverty does not consist so much in 

367 



368 Conclusion. 

not having enough to eat. as in not having the food one desires." 
Doubly true is this in sickness. The coarse fare which is the 
ordinary food of the poor is then loathed, and it is physiologically 
true that it often will not nourish if taken, and the monotony of 
diet actually starves the body. Delicacies, " tidbits,'' little surprises 
in diet, such as we have given numerous receipts for in the foregoing 
pages, are then not merely most grateful, but really necessary. It 
is, moreover, a curious fact, one constantly observed, and which we 
can interpret as a standing admonition to mutual kindly offices, that 
the palate of the sick is nearly always better pleased with a dish 
sent in by a neighbor than with the same prepared at home. The 
little peculiarities in its preparation which every housekeeper has, 
give it an agreeable diversity in flavor. 

But the sick ask more at our hands than food and shelter. The 
long, weary days, the longer, more weary, sleepless nights: how 
grateful to the worn and disturbed senses at such times, is the fresh 
fragrance of a bouquet of flowers, the cool scent of an aromatic 
water, such as bay water, cologne, or diluted vinegar, the sight of a 
few pretty prints, or the soothing sound of a gentle hymn. Da one 
sad case we remember, that of a fair young girl, a long time tossing 
in the low delirium of typhoid fever, nothing gave her quiet till 
two or three of her schoolmates stood round her bed and united 
their voices in a soft hymn, when she sank into a peaceful slumber. 

In this connection, we would recommend for imitation an 
admirable society in Philadelphia, organized by a number of charit- 
able ladies, the "Philadelphia Flower Mission," the chief purpose 
of which is to distribute bouquets and baskets of flowers, pot plants 
and fresh fruits, through hospitals and charitable institutions, and in 
the dwellings of the poor throughout the city. It gives away in 
this manner from eight to ten thousand bouquets annually, all of 
them contributed by the members and their friends, who have flower 
gardens and conservatories. Let such use as this be made of surplus 
wealth, and we shall hear no longer of "the war between labor and 
capital." Such charity is dictated by no monkish sentimentality, 
but is directed by the truest of physiological principles, and is 
inspired by the very spirit of Him who painted the lilies of the 
field with tones of beauty such as no earthly artist can approach. 



Charity to the Poor and Sick. 369 

Especially would we call the attention of the charitable to the 
condition of the children of the poor in our large cities. There 
are, in the first place, those waifs of humanity, the foundlings. 
About a fourth of all the children of the poor die in the first year 
of their life; but of those deserted little ones, hardly a fourth 
survive that year. The mortality of foundling hospitals, no matter 
how well cared for, is simply appalling ; but a very small fraction of 
the infants admitted to them live to come out again. Hence an 
eminent physician of New York city condemns them altogether, 
and recommends in their stead that arrangements shall be made 
with small farmers, and others living in country places, to take 
and care for the foundlings. This plan, adopted with gratifying 
success in certain European cities, is not more expensive, and should 
be introduced with us. 

Next to these the older children of poor parents claim our 
attention. Think of the child shut up the long, hot summer, in 
the foul alleys of the city, never seeing the green fields, its natural 
home, nor culling flowers, or chasing butterflies, its brightest of 
dreams. Shall we not give those little ones, at least once in a while, 
a breath of pure, fresh, country air, a brief escape from crowded 
tenement houses and dusty streets? With this object in view, 
charitable individuals in some of our cities have for several years 
subscribed to a fund to provide excursions for the children of the 
city poor. This is well ; but it is not necessary to wait for such 
organizations. Any one can readily — too readily! — find a child 
suffering and pining for country air, and at a small expense arrange 
with a farmer's family to keep it a few weeks during the summer. 
Then give anotber its turn, and at no more cost than a week for 
ourselves at the seaside, health and happiness can be distributed for 
a whole summer, on half a dozen little lives. 

Dr. Toner, of "Washington, has also suggested the establishment 
of large camps, with abundance of shade and pure water near them, 
for the accommodation of poor families in the summer, a most 
benevolent suggestion, which, it is to be hoped, will not be forgotten. 

We would add one more word to the recommendations which we 
have here written, and a word which, if the reader pass on unmindful 
of it, will frustrate his best attempts to help those who need his 



3/0 Conclusion . 

help. It is this : show your sympathy as well as feel it. Show it 
in word and in look, as well as in acts; show it in your softened 
tones, in tender inquiry, in patient listening to complaints, in 
consideration for the feelings of the humblest, in a demeanor as 
respectful in dreariest garrets as in most luxurious sick chambers. 
Without this, your deeds of mercy will neither bless you who give, 
nor those who receive. 

We add another and a final reflection. Sickness is to man a 
warning that this life is not his only one; that he is but a so- 
journer in the land, and must seek his true home beyond. There- 
fore, it is eminently proper at such times, when the condition of the 
invalid permits it, to recall to his mind the promises of religion and 
the loving kindness of Him who holds our destinies in His hand. 
It is not the time to excite religious fears or strong emotions, nor 
to discuss differences in religious opinions. It is not for us to 
pronounce judgment on our fellows, nor can we measure the good 
and evil of any man's life ; but every Christian, whatever opinions 
he may individually prefer, can always draw from the inexhaustible 
fund of God's promises, words of consolation and comfort for the 
sick and the wretched, which will cheer their minds, lighten their 
sufferings, and fit them better for the passage to the world beyond. 




APPENDIX. 
THE FAMILY HEALTH EECOED. 



THE OBJECT OF THE HEALTH RECORD. 

By means of the following schedules for a " Family Health Re- 
cord" any mother can, with very little labor, keep the health annals 
of each of her children. The jotting down in place of a word or 
two, or of an initial, every few months, will, in time, furnish orderly 
notes, extending from infancy over the whole life, always at hand 
for instant reference. The value to a family of such health archives 
can scarcely be over-estimated. No random, straggling memoranda, 
like those sometimes kept, compare in utility with these regularly 
noted facts, arranged upon a uniform plan. 

Every mother can and should be the historian of her children's 
health, and put upon permanent record her solicitude for their wel- 
fare. No careful housekeeper is ignorant of the usefulness of exact 
expense accounts ; few can fail to see the great importance of pre- 
serving exact health accounts, instead of trusting, as is usually 
done, such details to the memory, a guardian often at fault, and 
never fully competent. Who can recollect and give at once, and 
with accuracy, to a new physician, one, therefore, unacquainted 
with the family history and peculiarities, the prominent events in 
regard to the early life, the growth and the ailments of each mem- 
ber of the family, his or her susceptibilities to this or that disease, 
371 



37 2 The Family Health Record. 

to the effects of this or that food, medicine or mode of life? Yet 
such information throws that light upon the constitution of the 
invalid which is often the most needed, the most difficult to obtain, 
and the want of which often leads to the most lamentable errors of 
treatment. The register which we here give will enable any 
mother, at the trouble only of noting a word, a date, or a single 
letter, at long intervals of time, to treasure up, always ready for con- 
sultation, all the important facts relating to the temperament, pre- 
disposition, and ailments of her children. 

With the aid of this Family Health Record, properly kept, many 
a connection, which would otherwise remain unsuspected, will be 
observed between sicknesses remote from each other, but united by 
a chain of cause and effect, a common nature, or a similar origin. 
Family peculiarities and hereditary tendencies will, by it, be brought 
to light, which would otherwise escape attention. Predispositions 
to certain ailments frequently lurk in individuals and in families, 
unseen by all but the old family physician, whose knowledge of 
them cannot always be made available ; these records will make 
them apparent to every ordinary intelligence. 

In order that the nature of each serious ailment may be correctly 
stated, the mother should question the attending physician at the 
close of the illness, and at once make her notes. The precise facts 
only are wanted ; all theories and suppositions are useless. 

We need not enlarge upon the importance of a Family Health 
Record to every individual, family and community ; a moment's 
reflection will show what precious light would be thrown upon 
public as well as private hygiene if such a register, on a uniform 
plan, were kept for generations by every family of the land. 

It will be observed that the following register is arranged under 
right heads, and that it presents, therefore, eight separate tables, in 
blank, for filling up. They are all within the range of the mother's 
powers of observation. The first is devoted to descent, and gives 
the health and tendencies to disease of the immediate living relatives, 
and the age and cause of death of those deceased. Initials for filling 
up the columns of this table are furnished in the foot-note to it. 
On the blank page opposite, any additional particulars bearing on the 
subject may be recorded. The second table is for the purpose of record- 



ei 



The Family Health Record. 373 

in fe the weight at different ages. These comparative weights are of the 
greatest importance, and are not difficult to take. The average 
weight of a new-born child is seven pounds ; the extremes are from 
four to eleven pounds. The third table affords the means of noting 
the growth, particulars in regard to school life, and the diseases 
which manifest themselves during the period of active growth. 
The notes in reference to vaccination called for by this table should 
not be overlooked. A new-born child is easily measured by stretch- 
ing it upon a table, keeping its legs out straight, and drawing 
two lines, one touching the soles of the feet, the other the top of 
the head. Subsequent measurements are readily taken by having 
the child stand in stocking feet beside the case of the door, and 
resting a square on the top of the head. If a small four-sided 
post be prepared, two inches square and six feet and a half high, 
on its four faces may be inscribed the growth of four children of 
the same family, one face for each child. This, if kept, and carried 
from house to house, enables comparisons to be made at a glance. 
The fourth table is for the noting of ailments. Quite a number of 
the most common and the most important for recording are printed, 
and blanks left for others. The defects and diseases in the senses 
of sight and hearing are to be noted in the blanks provided for 
them by table fifth. The sixth and seventh tables are for facts 
in regard to Accidents and Operations, and Hygienic Habits. 
An obituary record ends the Kegister. 

PRACTICAL DIRECTIONS FOR KEEPING THE FAMILY HEALTH 
RECORD. 

Make the entries very brief; employ the initials as often as 
possible, in the place of writing out the words. 

Observe that there is ample space for keeping the health records 
of four children, that of one being upon the left-hand page and 
those of the other three on the right-hand page facing it. The full 
form, given on the left-hand pages, for the first child, is not repeated 
on the right-hand pages for the second, third and fourth child, 
as it is unnecessary to do so, it being easy to put down in the blank 
space there given to each child all the details that need be noted, 
if care be taken to record them in the same order as that called for 
by the ruled form on the opposite page. 
32 



The Family Health Record. 



DESCENT. 



I. Paternal. 

I II. Maternal. 

Father. 
Mother. 

ri. 

Brothers. -! 2. 



E. Sisters. 



Grandfather, 
Grandmother. 
Grandfather 
Grandmother. 



(Paternal. \ 
I. 



Uncles 

and 
Aunts. I Maternal. 



Living. 



Age 



Dead. 



Causes of Death. 



* Fill up this column by the use of the following initials : Very 
good (V.G.); good(G.); tolerably good (T.G.) ; delicate (D.) ; feeble 
(F.); confirmed invalid (I.). 

f Fill up this column by the use of the following initials : Tendency 
to brain disease (B.) ; to nervous affections (N.) ; to coughs, colds, and 
chest affections (C.) ; to rheumatism (ft.). 



374 



The Family Health Record. 
ADDITIONAL PARTICULARS. 



375 



The Family Health Record. 



WEIGHT. 



Age. 


i 


Age. 


_ap 


Age 


5 


Age. 






^ 




£ 




£ 




£ 




It>s. 




lbs. 




lbs. 




lbs. 


At birth, 




2 years, 




12 years, 




25 years, 




1 month, 




3 years, 




13 years, 




30 years, 




2 months, 




4 years, 




14 years, 




35 years, 




3 months, 




5 years, 




15 years, 




40 years, 




4 months, 




6 years, 




16 years, 




45 years, 




5 months, 




7 years, 




17 years, 




50 years, 




6 months, 




8 years, 




18 years, 




55 years, 




9 months, 




9 years, 




19 years, 




60 years, 




12 months, 




10 years, 




20 years, 




65 years, 




18 months. 




1 1 years, 




21 years, 




70 years, 





Ages at which the Weight has Diminished : 



f 1. Bodily fatigue : 
Hygienic Causes : 1 2. Mental fatigue : 



Causes of Diminished 
Weight : 



[ 3. Rapid growth : 

f 1. Bad habits : 
Morbid Causes: ■{ 2. Indispositions: 
[ 3. Sickness: 



The Family Health Record. 
OTHER CHILDREN. 



377 



The Family Health Record. 
GROWTH. 



Age. 


Height. 


Age. 


Height. 


Age. 


Height. 




Ft. 


In. 




Ft. 


In. 




Ft. 


In. 


At birth, 






7 years, 






14 years, 






1 year, 






8 years, 






15 years, 






2 years, 






9 years, 






16 years, 






3 years, 






10 years, 






17 years, 






4 years, 






1 1 years, 






18 years, 






5 years, 






12 years, 






19 years, 






6 years, 






13 years, 






20 years, 







A. Retarded growth : 
, B. Premature growth : 
1 C. Growth by leaps: 

D. Excessive growth : 



SCHOOL LIFE. 








Primary 

School. 


Grammar School. 


High Sch'l 
or other. 




Lower 
Classes. 


Upper 
Classes. 


Age when entering, . . 
Age when leaving, . . 
Interruption from Indispo- 
sition or Sickness, . . 











DISEASES IN GROWING. 







x. 


,£5 




d) 




c 














±> CO 


CO 












c 










= a 


&>3 




m z 








~Ph 








.5 
'3 

03 

a 


1 


§ 

3 


i 


.-so 
> 

02 


si 

S3 


"fa 

l_ 


9 


D 

M 
o 

13 


8 

© 


■g 

■a 


Age, . . . 








Duration, . 
























Severity, . . 

























When vaccinated : 

Did it take ? 

Date of vaccination 



37* 



The Family Health Record. 
OTHER CHILDREN. 



379 



The Family Health Record. 



AILMENTS. 



Disease. 



Constipation, . . 
Dysf>epsia, . . . 
Diarrhoea, . . . 
Colds in the head, 
Colds in the chest 
Sore eyes, . . . 
Running at the ears 
Boils, . . . 
Eruptions on the skin, 
Nose-bleed, . ". 
Neuralgia, . . . 
Rheumatism, . . 
Persistent cough, 
Spitting of blood, 
Night sweats, . . 
Vomiting of blood, 



Date. 



Season. 



Age 



Consequences. 



380 



The Family Health Record. 
OTHER CHILDREN. 



381 





The Family Health Record. 




SIGHT AND HEARING. 


I. 


Sight. 




A. Cross-eye: 






f Father: 




B. Near sight. 


1. Inherited. < Mother: 

[ Brother or sister : 

2. Time of appearing : 




( 1. Inherited: 
C. Far-sight. 1 

[ 2. Time of appearing : 




D. Diseases of the eyes : 


II 


Heaking. 




A. Diseases of the ear : 




(" 1. Of long standing : 
B. Deafness.] 

(. 2. Nervous : 



282 



The Family Health Record. 
OTHEB CHILDREN. 



383 



The Family Health Record. 



ACCIDENTS AND OPERATIONS. 

A. Falls: 

B. Blows and contusions : 

C. Bruises and scalds : 

1. Age : 

2. Side: 

D. Ruptures, -j 3 _ Causeg . 



•{ 



E. Foreign bodies. 



F. Poisoning. 



G. Injuries of the bones 
or joints. 

H. Surgical operations : 



A. Date of application : 

B. Date of leaving off: 

1. In the stomach: 

2. In the eye : 

3. In the ear : 

4. In the throat : 

1. Date: 

2. Substance: 

|_ 3. Consequences. 

f 1. Fractures: 
\ 2. Dislocations: 
[ 3. Sprains: 



£34 



The Family Health Record. 
OTHER CHILDREN. 



385 



The Fajnily Health Record. 


HYGIENIC HABITS. 






1. Fat : 






2. Lean: 


I Food : 


A. Food badly digested : ■ 


3. Milk: 

4. Vegetables: 




t 5. Fruit : 




B. Peculiar tastes in eating . 




A. Common duration : 




f rising : 
B. Hours of < 

( retiring : 






1. Peaceful sleep: 


II. Sleep: 




2. Continuous sleep : 

3. Interrupted sleep : 




C. Condition: 


4. Dreams: 

5. Nightmare: 

6. Grinding of the teeth : 

7. Habit of talking aloud : 




A. Activity or sluggishness: 


III. Exercise: 


B. Agility or address : 




C. Endurance of fatigue : 


f A. Date of beginning: 


IV. Gymnastics: \ B. Total duration. 

L C. Principal exercises: 


r A. Warm and thick: 
V. Clothing: < 

(B. Light: 


f A. Warm: 
VI. Bathing: J B. Cold: 


I C Sea: 


rA. Active: 
VII. Kind of Life : < 

{B. Sedentary: 



386 



The Family Health Record. 
OTHER CHILDREN. 



387 



Obituary Record. 



Date 
of Death. 



Age. 



Disease. 



388 



CLASSIFIED LIST OF ILLUSTRATIONS. 



Illustrations of the Structure of the Body.— The Teeth (2)— 
The Different Kinds of Bones (4)— The Framework of the Body (4)— 
The Muscles and Skin (5) — The Lungs and Means of Ventilation (3) — 
The Heart (3)— The Sense of Touch (1)— The Ear (3)— The Eye (2)— The 
Nervous System (1). Total, 28 engravings. 

Illustrations of Health Movements.— Home Gymnastic Exercises 
without Apparatus (28) — Movement Cure (4). Total, 32 engravings. 

Illustrations of Bandages and Dressings.— Bandages and Modes 
of Applying (5)— Irrigating a limb (1)— Surgical Cradles (1)— To Check 
Bleeding (7) — Dressings for Broken Bones (5) — A Handy Stretcher (1) 
— To Reduce Dislocations (8). Total, 28 Engravings. 

Illustrations of the Treatment for Drowned Persons, 4 en- 
gravings. 

Illustrations of the Treatment of Sundry Accidents, 8 engrav- 
ings. 

Illustrations of Baths and Inhalations, 4 engravings. 




The Inside of a Grinder, For Description, see p. 53. 

389 



390 



Illustrations of the Bones. 




Example of the Long Bones- 
The Thigh, p. 47-flg. 35. 



Example of the Flat Bones— The 
Shoulder Blade, p. 48— fig. 37. 





Example of the Short Bones— Example of the Irregular Bones— 

The Wrist, p. 48-fig. 36. A Vertebra, p. 48-fig. 38. 



Tllustraiwns of the Bony Framework of the Body. 391 




The Chesfc Cage, p.S&-£g.40L, 



The Spinal Column, 
p. 49-fig. 39. 





The Bones of the Abdomen. 
p. 50-fig. 41. 



The Skeleton, p. 50-flg. 42. 



392 



Illustrations of the Muscles. 





Muscular Fibre. Inside of a Hair. 

p.33-flg.4. p.30-fig.2. 




Knee-pan and Muscles. 
p. 35-flg. & 



Section of Skin. 
p. 27-fig. 1. 



Illustrations of Health Movements. 39; 

Home Gymnastic Exercises without Apparatus. 





Movement 2. 
p. 37-flg. 8. 



Movement 3, 
p. 37-flg. 9. 



Movement 4, 
p. 38— fig. 10. 






Movement 7. 
p. 38-fig. 13. 




Movement i 
p. 39— flg. 14. 




394 



Illustrations of Health Movements. 





Movement 10. Movement 11. Movement 12. 
p. 39-fig. 16. p. 39— fig. 17. p. 40-fig. 18. 



Movement 13. 
p. 40-fig. 19. 





Movement 19. 
p. 42-fle. 26w 



Illustrations of Health Movements. 395 






Movement 22. 
p 43— fig. 28. 




^::^% e^r; 



Movement 23. 
p. 43-ng. 29. 




Movement 24. 
p. 43- fig. 30. 



Movement 25. 
p. 44-fig. 31. 



/$ P% 




Movement 26. 
p. 44-fig. 32. 



Movement ! 
p. 45-fig. 34. 



396 Illustrations of Bandages and Dressings. 



Bandages and Dressings. 



A Roller Bandage, p. 202— fig. 1 




Applying a Roller, p. 202— fig. 60. 




A 4-tailed Bandage, p. 203— fig. 61. 



Illustrations of Bandages and Dressings. 397 




A Many-tailed Bandage, p. 203— fig, 




398 Illustrations of Bandages and Dressings. 




Surgical Cradles, p. 92— flg. 57. 




Bandage for Leg Sores, p. 198— fig. 58, 



Illustrations of Bleeding. 



399 



Bleeding and its Treatment. 




Bleeding from Forearm, p. 206— fig, 64. 




Bleeding from Finger. 
p. 207— fig. 65. 



The Use of a Key to Stop Blood, 
p. 208— fig. 66. 



400 Illustrations of Bleeding. 




Pressure on Armpit, p. 209— fig, 




Tourniquet on Arm. p. 209— fig. 68. 



Illustrations of Bleeding. 



40 1 




Pressure on Leg. p. 210— fig. 69. 




Tourniquet on Leg. p. 211— fig. 70. 



34* 



402 



Illustrations of Broken Bones. 



Broken Bones and their Treatment. 




W\ II 

Tying Legs for Transportation, p. 212— fig. 71. 




A Handy Stretcher, p. 212— fig. 72. 




Dressing in Broken Collar Bone. p. 213— fig. 



Illustrations of Broken Bones. 



403 




Dressing for Broken Upper Arm. p. 214— fig. 74. 




Dressing for Broken Lower Arm. p. 215— fig. 75. 



Box for Broken Leg. p. 216— fig. 76. 



404 Illustrations of Bones Out of Joint. 

Bones Out of Joint and their Treatment. 




Reducing a Lower Jaw Out of Joint, p. 217— fig. 77. 




Dressing for a Collar Bone Out of Joint, p. 218— fig. 78. 



Illustrations of Bones Out of Joint. 405 




Reducing an Arm Out of Joint, p. 219— fig. 79. 




Reducing a Dislocated Arm without Assistance, p. 219— fig. 80. 




A Finger Out of Joint, p. 221— fig, 



406 Illustrations of Bones Out of Joint. 




Reducing a Finger Out of Joint, p. 221— fig. 84. 




The Clove Hitch, 
p. 221— ng. 83. 



Reducing a Thigh Out of Joint, 
p. 220-fig. 81. 



Illustrations of Drotvning. 



407 



Drowning and its Treatment. 




Artificial Respiration, p. 226-fig. 87. 




The First Movement, p. 228— fig. 



408 Illustrations of Drowning. 




The Second Movement, p. 229— fig. 




The Third Movement, p. 229— fig. 90. 



Illustrations of Sundry Accidents. 409 



Sundry Accidents. 




Cupping Back of Neck. 
p. m-ng. 85. 




Poison Bag of a : 
p. 235-flg. 91. 




IP 






Extinguishing Flames on Clothing, p. 223— fig. 86. 





Removing an Object from the Eye. Dressing for an Injury to the Eye. 
p. 239— fig. 92. p. 240— fig. 93. 

35 



41 o Illustrations of Sundry Accidents. 




dressing a Clean Cut. p. 245-flg. 95, 





Dressing for Lacerated Ham String. 
p. 244— fig. 94. 



Dressing for Wounds of Scalp, 
p. 246— fig. 96. 



Illustrations of Passive Movements. 41 1 



Passive Movements. 





Arm and Body Movement. 
p. 247— fig. 97. 



Body Movement, 
p. 247— fig. 98. 




The Hip Movement, p. 247— fig. 99. 




Leg Movements, p. 248— fig. 100, 



412 



Illustrations of Lungs and Heart. 



The Lungs and Blood. 
W 




Inside of the Heart, p. 66— fig. 47. 



Illustrations of Circulation and Capillary Vessels. 4 1 3 



Plan of the 



35* 




Magnified Capillary V 



414 



Illustrations of Nerves. 
The Blood and Nerves. 

H^v f^f\ Ah la /&H A 






The Feelers of the Skin. p. 77— fig. 




The Brain, Spinal Cord and Nerves, p. 86— fig. 56. 



Illustrations of the Eye. 



415 



Eye and Ear. 




■HP 

The Eyeball and its Muscles, p. 81— fig. 54. 




The Chamber of the Eye. p. 83— fig. 55. 



416 



Illustrations of the Ear. 




The Little Bones in the 
Ear. p.80-fig. 52. 



The Outer, Middle and Inner Ear. p. 80— fig. 53. 



Illustrations of Room and Window Sash. 417 
Ventilation. 



|4- CUBIC 
FEET 



«, 1 5 |T EET yC- 

Dimensions of a Room. p. 32~fig. 3. 





Window Sash Ventilator, p. 60— fig. 48. 



41 8 Illustrations of Bathiiig Apparatus , etc. 

Baths, Etc. 




Home-made Shower Bath, 
p. 331-fig. 104 



An Inhaling Bottle. 
p. 351-fig. 105. 




Hip-Bath Tub for Children. 
p. 294— fig. 101. 




Lancing a Child's Gams, 
p. 307-fig. 102. 



INDEX 



PAGE 

ABDOMEN, the, ... 50 
Accidents, . . . .200 

Acid, carbolic, • 344 

oxalic, .... 253 

prussic, .... 253 

treatment, in cholera, . 177 

burns by, . . . . 225 

poisoning by, . . . 249 

Acne, 191 

Aconite, poisoning by, . . 249 

Addison's disease of kidneys, . 186 

Adhesive plaster, how to use, . 245 
Affusion, cold, . . . .338 

Ague, 114 

Air, amount used in respiration, 5S 

foul, in sick-room, . . 94 

how changed in the lungs, 59 

of sick-room, . . 93 

pure, as an anodyne, . . 358 

fresh, as a tonic, . . 88, 274 

in consumption, . . . 166 

size of rooms, ... 32 

the medium of sound, . 80 

Air-bath, warm, . . . 337 

Alcoholic poisoning, . . 249 

Alcoholism, .... 142 

Alkalies, burns by, . . . 225 

poisoning by, . . . 249 

Alopecia, 194 

Alum emetic, .... 345 

poultice, .... 359 



Ammonia, .... 

poisoning by, 

Anaemia, or poverty of the 

blood, .... 

Anasarca, or general dropsy, . 

Aneurisms, .... 



Angina, 

pectoris, 
Animal foods, table of, 
Ankles, weak, in children, 
Anodynes, 

six receipts, 
Antidotes (under poisons), 
Antimony, poisoning by, 
Aorta, the, 
Aperients, 
Apoplexy, 
Appetite, . 

loss of, 
Apple water, receipt, 
Applying cold, . 

cold affusions, . 

heat, . 
Apthse, ... 

of infants, . 
Arm, broken above elbow, 

broken below elbow, 

out of joint, reducing, 
Arnica lotion, . 
Arrowroot blanc-mange, 

drink, receipt, 

poultice, 
Arsenic, 
Arteries, the, . 

bleeding from, 

swelling of, 
Arthritis, or gout, 
Asphyxia, 

cholera, 
Asthma, . 

cold baths for, 

hay, . 
Auscultation in consumption, 



419 



420 



Index. 





PAGE 


BACK-ACHE, in piles, 


. 179 


Backening boils, 


. 196 


felons, 


. 197 


Baldness, 


. 194 


receipts, 


. 363 


Bandage for scalp wounc 


, . 246 


for the eye, 


. 240 


four-tailed, 


. 203 


many-tailed, 


. 203 


roller, 


. 201 


temporary, 


. 212 


Bantingism, . . 


. 64 


Barbers' itch, . 


. 192 


Barley gruel, receipt, 


. 325 


water, receipt, . 


. 322 


Baryta, poisoning by, 


. 250 


Bath, alkaline, . 


. 336 


bark, . 


. 336 


bran, . 


. 336 


eold, . 


. 334 


douche, 


. 338 


foot, . 


. 338 


gelatine, . 


. 336 


hip, . 


. 338 


hip, for children, 


. 294 


iron, . 


. 337 


liver of sulphur, 


. 337 


mud, . 


. 338 


mustard, 


. 337 


oil, . 


. 336 


Roman, 


. 337 


Russian, 


. 337 


salt water, . 


. 337 


sand, . 


. 33S 


shallow, 


. 338 


shower, 


333, 338 


sitz, . 


. 338 


soap, . 


. 336 


sponge, 


. 339 


starch, 


. 336 


Turkish, . 


. 337 


turpentine, 




valerian, . 


. 336 


vapor, medicated, 


. 337 


vapor, simple, . 


.. 337 1 



Bath, warm, 

warm air, . 
Bathing, .... 

for delicate children, 
Baths, kinds, uses, etc., . 
medicated, . 
temperature, 
Bath-tub, home-made, 
Batter pudding, receipt, . 
Bed-clothing, . 
for the sick, 
Bed-sores, 

in typhoid fever, 
Bed-wetting of children, . 
Beef and hen broth, receipt, 

tea, two receipts, 
Belladonna, poisoning by, 
Belly-ache, . 

dry, 

Belts, hydropathic, . 

Bile, the 

retention of, or jaundice, . 
Bilious cholera, 

colic, .... 
diseases, powder for, . 
diseases, dandelion tea for, . 
pneumonia, 
Biliousness, . 
Bismuth, poisoning by, . 
Bite of a dog, . 
Bites of insects, serpents, spi- 
ders, etc., 
Bitter-sweet, poisoning by, 
Black heads, .... 
Black vomit, or yellow fever, . 
Bladder, disease of, . 

inflammation or catarrh, . 
stone or calculus, 
weakness, 
Blanc-manges, four receipts, . 
Blebs on the skin, . 
Bleeding after tooth-drawing, . 
from arteries, . . 206 
leech-bites, 
the lungs, .... 



PAGE 

. 335 

. 337 

. 33? 

. 275 

. 333 

, 336 

, 334 

, 333 

330 

31 

92 

204 

105 

303 

327 

326 

250 

170 

170 

342 

62 

178 

175 

170 

341 

350 

163 

168 

250 

205 

206 

250 

191 

118 

187' 

187 

188 

187 

329 

195 

207 



165 



Index. 



421 





PAGE 


PAGE 


Bleeding from the nose, . 


208 


Bowels, the, .... 


63 


wounds, to check, 


206 


looseness of, . 173, 297 


, 303 


piles, .... 


178 


palsy of, . 


172 


to check, wound in arm, 


209 


stricture of, ... 


172 


to check, wound in leg, 


210 


wind in, 


170 


Blisters, blood . 


196 


Bow-legs, 


52 


from poison vine, 


253 


Boxing as exercise, . 


45 


of the skin, 


195 


Brain, the, .... 


85 


of the feet, 


196 


compression of, . 


222 


to make and use, 


339 


concussion of, . 


222 


Blood, the 


66 


the seat of sensation, . 


87 


arterial, 


71 


of voluntary motion, . 


87 


course in circulation, 


68 


water on, in children, 


268 


changes in circulation, 


71 


Bran poultice, .... 


359 


its two-fold office, 


71 


Brash, weaning, of infants, 


303 


poverty of . 


146 


Bread, and milk poultice, 


360 


spitting, 


165 


and water poultice . 


358 


venous, 


71 


jelly, receipt, 


329 


vomiting of 


168 


pudding, receipt, 


330 


watery, 


146 


sauce, receipt, . 


327 


Bloodlessness, or poverty of th< 




soup, receipt, 


327 


blood, 


146 


Breath, foul, mouth- washes for, 


363 


Bloody flux, or stools, 


174 


Breathing, . . . . 


58 


urine, 


188 


in Consumption, 


165 


Blotches, face, . 


193 


through the nose, 


75 


Blows, .... 


222 


through the skin, . 28, 59 


Blue mass, substitute for, . 


341 


Bright's disease, 


184 


Blushing, .... 


29 


Broken bones (see also Frac- 




Body, like steam-engine, . 


64 


ture), . 


211 


three divisions of, 


49 


heart, ..... 


181 


waste and repair of, . 


72 


limb, irrigating, 


203 


Boils, .... 


196 


ribs, 


214 


blind,. 


196 


Bromides, the, .... 


101 


Bones, the, 


47 


Bronchial tubes, 


57 


broken, 


211 


Bronchitis, .... 


158 


number of, in body, . 


48 


epidemic, .... 


117 


of the extremities, 


50 


of children, 


293 


head, .... 


49 


Bronzed skin, . 


193 


trunk, 


49 


Broths, receipts, 


326 


out of joint (see Dislocatio 


1). 


Bruises, 


222 


Bone-setting, ... 21 


7,222 


Bunions, 


196 


Borax wash, 


355 


Burns, 


223 


Bowel, falling of, in children, 


301 


by acids, ... 


225 


inflammation of large, 


174 


from gunpowder, 


243 


inflammation of lower, 


172 


lime, potash, etc., 


225 



422 



Index. 



PAGE 


CALCULUS in the bladder . 


188 


Calves'-feet jelly, 


330 


Camphor, for pain, . 


357 


liniment, .... 


353 


ointment .... 


356 


poisoning by, 


250 


Cancers 


316 


skin, . 


316 


Canker of mouth, in infants, . 


286 


sores, 


190 


Capillaries, the 


69 


Carbolic acid 


341 


Carbonic acid gas, in breathing, 


59 


Carbuncle, .... 


196 


Carriage-riding, 


45 


Carrot poultice, 


359 


Castor oil, .... 


340 


Catarrhal fever, or cold in the 




chest, .... 


158 


Catarrh, autumnal, . 


157 


epidemic, .... 


117 


gastric, .... 


168 


inhalations for, 


351 


nasal, .... 


156 


of the chest, 


15S 


of the ears, 


310 


of nose, or ozsena, 


157 


children's, .... 


284 


summer, .... 


157 


Cathartics, cautions, etc. . 


340 


eight receipts, . 


340 


Caudle, receipt, 


324 


Caustics for cancers, 


317 


Cellars, foul, to disinfect, 


314 


Chamber utensil in sick-room, . 


95 


Chambers, Prof., on food for 




sick, .... 


331 


Change of air in convalescence, 


99 


of climate, in consumption, 


167 


Chapped hands, 


192 


skin, salve for, . 


356 


receipts, .... 


364 


to prevent, .... 


365 


Charcoal fumes, apparent death 


237 


poultice, .... 


359 



PAGE 
Charpie lint, .... 354 
Chest diseases, vapor baths for, 337 
pains in, in consumption, . 165 
stabs in, . . . . 245 
Chewing the food, . . .61 
Chicken broth, .... 326 
pox, ... .264 

Chilblains, . . . .231 
liniment for, . . . 353 
Children, bones not easily bro- 
ken, .... 47 
breathing through mouth, . 74 
cross-eyes, . . .82, 309 
deformities, ... 52 
delicate, . . . .274 
doses, in this work, . . 255 
emetics, .... 345 
eruptions from scrofula, 273 304 
frightening, . . . 282 
galling, or rubbing, . . 304 
hip-bath, . . . .294 
itching, etc., from calculus, 188 
leeches, .... 352 
measuring, . . . 373 
mistaken care of ears, . 310 
of the poor, . . . 369 
picking the ear, ... 78 
picking the nose, . . 74 
scrofulous symptoms, . 271 
* short sight, ... 84 
things in ear, . . . 240 
things in nose, . . . 241 
vaccination, . . 264, 266 
wetting the bed, . . 303 
See also various diseases, etc. 
Chills, or chills and fever, . 114 
and fever, dogwood tea for, 349 
Chloral, for pain, . . . 357 
Chlorine as disinfectant . . 344 
Chloroform liniment, . . 354 
Chocolate milk, receipt, . . 324 
receipt for making, . . 324 
Choke-damp, . . . .237 
Choking, in eating, etc., . . 241 
Cholera, Asiatic, . . . 175 



Index. 



423 







PAGE 




PAGE 


Cholera, asphyxia, . 


. 175 


Complexion, 


29 


bilious, 




. 175 


to improve, 


365 


epidemic, . 




. 175 


Compress, wet, . 


339 


Indian, 




. 175 


•Concussion of brain, 


222 


infantum, . 




. 297 


Constipation, . 


172 


malignant, . 




. 175 


Consumption, . 


165 


morbus, 




. 175 


drugs of small value, 


166 


Chorea, 




. 155 


croton oil liniment for, 


344 


Chronic diarrhoea, 




. 173 


Consumptives, inhalations for, 


351 


Chyle and chyme, 




. 62 


diet for, 


321 


Circulation of the blood, 


. 66 


Contagion, danger increased in 


Cleanliness about dwelling 


?s, . 31 


close rooms, . 


94 


of sick room, 


. 96 


small-pox, . 


123 


of persons of sick, 


. 98 


Contagious diseases. See Small- 


Clothing, . 


. 30 


pox, Measles, "Whooping 


on fire, 


. 223 


Cough, Scarlet Fever, etc.. 


to disinfect, 


. 345 


Contusions, 


222 


Club-foot, . 


52, 314 


Convalescence, . 


99 


Clysters, . 


. 341 


Convulsions, or epilepsy, 


153 


Cod-liver oil, . 


. 166 


of children, 


279 


Coffee as an anodyne, 


. 357 


cold douches for children's 


338 


for the sick, receipt, 


. 324 


warm bath for, 


336 


Cold affusions, . 


. 338 


Cooking, etc., for the sick, 


320 


bath, . 


. 334 


Copper, poisoning from, . 


250 


excessive, effects of, 


. 231 


Copperas, as a disinfectant, 


345 


in the chest, 


. 158 


poisoning by, 


251 


in the head, 


. 156 


Corns, .... 


197 


June, . 


. 157 


Corpulency, to reduce, 


64 


modes of applying, 


. 342 


Corrosive sublimate, 


250 


rose, . 


. 157 


Coryza, or cold in the head, 


156 


sore, . 


. 198 


Costiveness, 


172 


to prevent sick from t 


aking, 94 


Cough medicines, receipts, 


349 


Colds, medicines for, recei 


pts, 349 


whooping, . 


291 


of children, 


. 293 


whooping, cold baths for, 


335 


Colic, 




. 170 


Coughs, .... 


. 158 


calamus tea for, 




. 350 


of children, 


. 293 


camphor for, 




. 357 


Counter-irritants, 


. 342 


lead, or painters 


, 


170, 172 


Cramp colic, 


. 170 


of children, 




. 295 


in swimming, 


. 227 


of infants, . 




. 171 


Cramps in cholera, . 


. 176 


Collapse, in cholera, 




. 176 


Cream of tartar, effervescing, 


. 340 


Collar-bone, dislocation oJ 


. 218 


jalap and, . 


. 341 


fracture of, 


. 213 


Croquet-playing, 


. 45 


Colitis, or dysentery, 


. 174 


Cross eyes, 


. 82 


Columbo and ginger 


tonic 


. 361 


in children, 


. 309 



424 



Index. 





PAGE 


Croton oil as an irritant. . 


353 


liniment, . 


343 


Croup, onion poultice for, 


360 


spurious, or spasmodic, 


290 


true, or membranous, 


288 


Crushed hand or fingers, . 


311 


limb, 


244 


Cushions, air and water, . 


92 


Cupping, 


344 


dry, 


344 


wet, 


344 


Currant jelly, . 


330 


Curvature of the spine, . 


313 


Cutlet, invalid's, 


328 


Cuts, 


244 


Cystitis, 


187 


DEAD, laying out, . 


254 


Death, apparent, from gas, etc., 


237 


strychnine, 


254 


sudden, from aneurism, . 


183 


heart disease, 


181 


Dancing as exercise, 


45 


Dandruff, 


194 


receipts, .... 


3G4 


Debility forbids cold baths, 


335 


forbids emetics, . 


345 


Decline (marasmus) in child- 




ren, . 


269 


Deformities, from burns, etc., . 


225 


in bones, .... 


52 


muscular, and cure, . 


46 


spinal curvature, 


313 


Delicate children, . 


274 


Delirious patients, . 


98 


Delirium tremens, 


142 


Dengue, or break-bone fever, . 


116 


Dentition, troubles of, 


258 


Deodorizers, .... 


344 


Derbyshire neck, 


197 


Diabetes, 


189 


Diarrhoea, 


173 


medicinal teas for, 


349 


of children, . . 297 


,303 



1 rice water," in cholera, 



PAGE 

Diarrhoea, tonic preparation for, 361 

Diet, after starvation, . . 145 

for corpulency, ... 64 

dyspeptics, . . . 168 

thinness of flesh, . . 64 

in diabetes, . . . 189 

diarrhoea, . . . .173 

dysentery, . . . .174 

sickness, its importance, . 320 

various diseases, . . 320 

See also Food. 

Digestion, .... 61 

ice as an aid to, . . . 323 

of animal foods, . . 327 

weak, diet for, . . . 321 

Digitalis, poisoning, . . . 251 

Dipsomania, .... 142 

Diphtheria, .... 161 

of children, . . . 290 

Disinfectant, fresh earth as, . 345 

Disinfectants, principal, . . 344 

Dislocation of bones, . . 217 

collar-bone, . . . 218 

fingers, .... 221 

hip, 220 

jaw, 217 

shoulder, .... 218 

toes, 221 

Dislocations, redu«ing, . 217, 222 

Dog, bite of, . . . 205 

Douches, 338 

Draughts, causing cold, . . 156 

Dressing blisters, . . . 340 

burns and scalds, . . 224 

delicate children, . . 275 

wounds, .... 243 

wounds and sores, list fr^ . 354 

Drink, a soothing, . . . 324 

milk and cinnamon, . , 324 

Drinks, for the sick, receipts, . 322 

Dripping sheet, the, . . 339 

Dropsy, 149 

after scarlet fever, . , 262 
hydrocele, . . ,149 

in Bright's disease, . . 186 



Index. 



425 



PAGE 

Dropsy in oedema, . . . 149 
of brain in children, . 268 

of head, . . . .149 
of heart, . . . .180 
of ovaries, .... 149 
teas for, .... 349 

Drowning, .... 225 

Marshall Hall's Method, . 227 
Eules of Life Saving So- 
ciety, . . . .228 
Silvester's Method, . . 226 

Drugs, action, selection, etc., . 100 
great variety needless, . 100 

Dysentery, .... 174 
medicinal teas for, . . 349 

Dyspepsia, . . . .168 
diet in, . . . .321 
drugs of minor value, . 168 

Dwellings, . . . .31 

EAR, the, 77 

practices that injure, . 78 
running from, . . .310 

things in, . . . . 240 

to remove wax in, . . 78 

Earache, 311 

Earth closets, .... 345 

fresh, as disinfectant, . 345 

Earwig, to remove, . . . 240 

Eczema, 190 

of the scalp, . . . 194 

Egg and sherry, receipt, . . 323 

Electricity for stiff joints, etc., 247 

Elm, slippery, poultice, . . 360 

Emetic, alum, .... 345 

mustard, .... 345 

salt and water, . . . 345 

salt, common, . . . 345 

Emetics, 345 

Epidemics. See Catarrh, Cho- 
lera, Diphtheria, Dysen- 
tery, Fever, Small-pox, 
etc. 

Epilepsy, or falling sickness, . 153 

Epsom salts, rhubarb and, . 340 

36* 



PAGE 
Exercise, . . . . .36 
for consumption, . 166, 167 
arious kinds, ... 45 
violent, and aneurisms, . 182 
Expectorant, receipt for, . . 349 
Extinguishing flames on cloth- 
ing, 223 

Extremities, the, ... 50 

Eye, the 81 

bandage for, . . .240 
black, to prevent, . . 222 
defective action, . . 84 

lime, soda, or potash in, . 240 
things in, to remove, . 239 

Eyelashes, ingrowing, . . 310 
Eyes, sore, of children, . . 308 

weak, 85 

Eye-wash, alum, . . . 346 
arnica, .... 346 
brandy, .... 346 
tea, 346 

FACE blotches, . . .193 
grubs in, . . x . ■ . 191 
washes for, .... 365 

Fainting, ... . 150, 1S2 
cold douche for, . . 338 

Shakspeare quoted, . . 70 

Faintness, .... 230 

from hemorrhages after 

wounds, .... 207 
from " shock," . . . 200 

Falling sickness, or epilepsy, . 153 

Falls from horse, scaffolding, 

etc, 223 

injuries from, . . . 230 

Family gymnastics, . . 36 

medicine chests, . . 101 
thermometers, . . .102 
health record, . . .371 

Fatty degeneration of heart, . 180 

Feet, blisters of, . . . 196 

fetid, 198 

ointment for fetid, . . 365 

Felon, bone, . . . . 197 



426 



Index. 





PAGE 




Felon, flesh, . . . 


197 


Fever, ship or typhus, 


Festering from splinters, etc, 


242 


slow nervous, 


Fever and ague, 


114 


sponging body in, 


and ague, dogwood tea for 


349 


spotted or typhus, 


autumnal, . 


103 


swamp, or chills and, 


bilious, 


111 


teething, of infants, . 


" or typhus, 


106 


typhoid, . . 


" remittent, 


111 


typhus, . . . 


blisters, 


190 


wasting, of children, . 


" receipt, 


364 


winter, 


brain or typhus, 


106 


worm, of children, . 


breakbone, 


116 


yellow, 


camp or typhus, 


106 


Fingers, broken, 


catarrhal, or influenza, 


117 


crushed, 


" or cold in chest 


158 


dislocation, 


chills and, 


114 


jammed, 


chills and, cold affusion for 


338 


webbed, 


common continued, . 


103 


Fire, clothing on, 


dandy, 


116 


Fish-hooks in flesh, . 


diet in, 


. 320 


Fistula of the anus, . 


fall or typhoid, . 


. 103 


Fit, apoplectic, 


gastric, of infants, 


. 256 


epileptic, . 


hay, .... 


. 157 


fainting, 


hospital or typhus, . 


. 106 


of hysterics, . 


infantile remittent, . 


. 256 


Fits of children, 


infantile typhoid, 


. 256 


cold douche for, 


intermittent, 


. 114 


onion poultice for, 


jail or typhus, . 


. 106 


warm bath for, 


littoral, 


. 114 


Flannel underclothing, . 


low or typhus, . 


. 106 


Flannels, hot, 


lung, .... 


. 163 


Flatulence, 


" of children, 


. 294 


Flaxseed meal poultice, . 


malarial or bilious, . 


. Ill 


.Fleabites, 


" or chills and, 


. 114 


Flesh, the, 


malignant bilious, 


. 118 


pins, needles, etc., in, 


" typhus, 


. 118 


splinters, etc.. in, 


marsh, or chills and, . 


. 114 


Flour gruel, receipt, 


nightsoil or typhoid, . 


. 103 


Fluttering of the heart, . 


paludal, 


. 114 


Flux, bloody, 


petechial, . 


. 106 


Fly poison (under arsenic) 


puking, 


129 


Fomentation, . 


putrid or typhoid, 


103 


mustard, . 


" or typhus, 


106 


opium, 


remittent, . 


111 


ordinary, . 


scarlet, 


259 


turpentine, 



Index. 



427 





PAGE 




PAGE 


Fomentation, turpentine, an 




Gargle of alum, 


347 


other, 


347 


brandy, 


347 


Food, animal, different kinds, 


327 


chlorate of potash, 


347 


best when enjoyed, . 


76 


lime water, 


347 


for the sick, rules, 


322 


sage and linseed, 


347 


forming and warming, 


. 64 


Gases, apparent deaths from, 


237 


giving it to the sick, 


331 


Gastric catarrh , 


168 


starved, cautions 


145 


fever, of infants, 


256 


variety necessary, 


65 


juice, .... 


62 


want of, 


65 


ulcer, 


168 


why necessary, . 


61,64 


Gastritis, .... 


168 


See also Diet. 




Gelatine blanc-mange, 


330 


Foot baths, 


33S 


Glands of neck, swellings of, 


317 


warmer for the sick, . 


. 92 


Goitre, .... 


197 


Foul breath, mouth washes fo 


r, 363 


Goulard- water wash, 


355 


Fowl and egg, minced, receipt 


328 


Gout, .... 


137 


and rice, receipt, 


. 328 


in stomach, 


172 


Fowler's solution (arsenic), 


. 250 


Gravel, or kidney stone, . 


186 


Foxglove or digitalis, 


. 251 


goose-grass tea for, . 


349 


Fracture of arm, above elbow, 


214 


hip-bath for, 


338 


arm, below elbow, 


215 


Gripes of children, . 


295 


bones, 


. 211 


Grippe la, or catarrhal fever, 


117 


comminuted, 


. 213 


Gross, Prof., on diet for sick, 


321 


compound, 


. 213 


Grubs in the face, 


191 


simple, 


. 213 


Gruels, receipts, 


325 


collar-bone, 


. 213 


Gum boils, 


190 


fingers, 


. 215 


Gunpowder burns, etc., . 


243 


jaw, lower, 


213 


Gunshot wounds, 


. 243 


leg, .... 


. 216 


Gymnastics, 


. 36 


ribs, .... 


. 214 






skull, 


. 213 


HAIE, diseases of, . 


194 


thigh, 


. 216 


falling of, . 


. 194 


Freckles, .... 


. 193 


tonics, 


363 


to remove, . 


. 365 


Hairs, . . . . 


. 29 


Freezing mixtures, . 


. 342 


gray, from fear, etc., . 


. 30 


Frights to children, . 


. 282 


Ham-string, rupture of, . 


244 


Frontispiece described, . 


. 63 


Hand, crushed, 


. 311 


Frost bites, 


. 230 


Hands, chapped, 


. 192 


Frozen limbs, . 


. 230 


receipts, . 


364 


Fumigations, . 


. 337 


clammy, receipt, 


365 


Furniture of the sick-room, 


. 91 


lotioa for, . 


364 


Furuncles, 


. 196 


Hanging, apparent death from 


237 






Hang-nails, 


195 


GALL stones, . 


. 170 


Hare lip, .... 


307 


Galling in children, 


304 


Hay asthma, 


157 



428 



Index. 





PAGE 




PAGE 


Hay fever, 


. 157 


Hernia, vomiting in, 


. 171 


Hartshorn, 


. 101 


Herpes, 


. 190 


and oil liniment, 


. 353 


Hives, 


. 191 


Head, the, 


. 49 


dry, . 


. 191 


dropsy of, . 


. 149 


Hoarseness, 


. 160 


Headache, 


. 133 


Horrors, the, 


. 142 


bag of hot salt for, 


. 348 


Horseback-riding, 


. 45 


neuralgic, . 


. 132 


Hot bricks, sand, bottles, 


etc., . 348 


quinine for, 


. 357 


Household remedies, 


. 99 


Health, means of promot 


ng, . 358 


Hunger, 


. 65 


mental, how promote 


d, . 88 


Hydrocele, 


. 149 


record, family, . 


. 371 


Hydrocephalus, 


. 149 


Hearing, sense of, . 


. 77 


in children, 


. 268 


and sound waves, 


. SO 


Hygienic directions, 


. 358 


Heart, the, 


. 66 


receipts, personal, 


. 361 


diseases, 


. 180 


Hysterical ailments, cold 


bath 


forbid cold be 


iths, . 335 


for, . ' . 


. 335 


forbid emetic 


s, . 345 


persons, diet, 


. 321 


dropsy of, . 


. 180 


Hysterics, . 


. 154 


fatty, 


. 180 






fluttering of, 


. 180 






neuralgia of, 


. 180 


ICE, for the sick, . 


. 323 


palpitation of, . 


. 180 


India ink marks, 


. 193 


rheumatism of, . 


. 180 


Indigestion, 


. 168 


Heart-break, 


. ISO 


in consumption 


. 165 


Heart-burn, 


. 168 


Infantile atrophy, 


. 269 


Heat, applying, 


. 347 


hectic, 


. 256 


endurable, if dry, 


. 27 


icterus, 


. 266 


moist, applying, 


. 347 


remittent fever, . 


. 256 


prickly, 


. 191 


typhoid, 


. 256 


Heat-stroke, 


. 235 


Infants, canker of mouth 


. 286 


Hemorrhage, see Bleedint. 




clothing, 


. 31 


Hemorrhoids, . 


. 178 


colic, . 


171,295 


Hereditary diseases. See 


\sth- 


dropsy of spine, . 


. 314 


ma, Consumption, E 


^rof- 


lancing the gums, 


. 306 


ula, St. Vitus' Dane* 


,etc. 


looseness of bowels, . 


. 303 


Hiccough, in dyspepsia, . 


. 169 


measuring, . 


. 373 


Hip-baths, 


. 338 


milk crust, . 


. 304 


forchildren, 


. 294 


nursing sore mouth, . 


. 285 


Hip disease of children, . 


. 312 


rupture, 


. 316 


dislocation of, . 


. 220 


snuffles, 


. 284 


Henbane poisoning, . 


. 251 


squinting, . 


. 309 


Herb teas, 


. 348 


teething, 


. 258 


Hernia, . 


. 232 


weaning, . . 


. 297 


in children, 


. 315 J 


weaning brash, . 


. 303 



Index. 



429 



PAGE 
(See also Children and various 

diseases.) 
Infection, to destroy, . . 95 
Inflammation, active, forbids 

cold baths, . . . 335 
artificial, .... 342 
of bladder, . . . .187 
bronchial tabes, . . . 158 
kidneys, .... 184 
large bowel, . . . 174 
larynx . . . .160 
lower bowel, . . . 172 
of lungs, . . . .163 
of lungs, in children, . . 294 
parotid, . . . .263 
pleura, .... 103 
stomach, . . . .169 
tonsils, . . . .160 
Influenza or catarrhal fever, . 117 
or cold in the head, . . 157 
Injection, astringent, . . 341 
purgative . . . .341 
Injections, .... 341 

nutritious, .... 342 
Inhalations, .... 350 
balsam of tolu, . . . 351 
carbolic acid, . . .351 
creasote, . . . .351 
cubebs and carbolic acid, . 351 

tar, 351 

Inhaler, a simple, . . . 350 

In-knee, 315 

Insects, bites of, 200 

Iodide of potassium, for pain, . 357 

Iodine, 102 

paint, 334 

poisoning by, . . .251 
stains, to remove, . . 360 
Irish moss blanc-mange, . . 330 
Iron, tonic preparations of, . 361 
Irrigating a limb, . . . 203 
Irritants for the skin, . . 353 
Isinglass jelly, . . . .329 

Itch, 192 

bakers', . . . .190 







PAGE 


Itch, barbers', . 


192 


bath, . 




190 


beard, 




192 


bricklayers', 
camp, 




190 
191 


grocers', 
ground, 
night, 
soldiers', 




199 

191 

m 

191 


washerwomen's, 


190 


winter, 


191 


Itching from poison vine, . 253 
of parts in children, . 1S8, 257 


JALAP and cream of tartar, 


341 


Jaundice, .... 


177 


in children, 


266 


Jaw, dislocation of, . 
lower, fracture of, 
Jellies for invalids, receipts, 
Jimson weed, poisoning, . 
Joints, the, . 


217 
213 
329 
253 
51 


stiff, passive movements, 
cold douche for, 


246 
338 


KIDNEYS, . . 


72 


Addison's disease of, . 


186 


Bright's disease, 


184 


congestion of, 


184 


hip-bath for, 
inflammation of, 
stone or gravel, . 
King's evil, or scrofula, . 


184 
338 
184 
186 
145 


in children, 


271 


Knee-pan, 
Knock -knee, 




34 
315 



LACTEALS,the ... 62 

Lancing the gums of infants, . 396 

Laudanum, poisoning by, . 252 

Laxatives, .... 340 

Laying out the dead, . . 254 
Lead colic, . . . 170, 172 

poisoning, .... 251 



43° 



Index, 





PAGE 




PAGE 


Lead wash, 


. 355 


Lotions for lips and hands 


, . 364 


Leeches and leeching, 


. 352 


Lumbago, mustard liniment for, 353 


Leg, broken, 


. 216 


Lunar caustic, poisoning by, . 252 


bandaging, 


• 203 


stains, to remove, 


. 366 


sore, .... 


. 198 


Lung fever, 


. 163 


Lemonade, two receipts, . 


. 322 


of children, 


. 294 


effervescing, 


. 322 


Lungs, the, 


. 57 


Leprosy .... 


. 192 


bleeding from, . 


. 165 


Lice, body, 


. 193 


inflammation of, 


. 163 


crab, .... 


. 193 


offices in circulation, 


. 71 


head, .... 


. 193 


penetrated by stab, , 


. 245 


Lichen, .... 


. 191 






Light of the sick-room, . 


. 90 


MAGNESIA and rhubarb 


, . . 340 


Lightning, stroke of, 


. 237 


calcined, 


. 341 


Limb, broken, irrigating, 


. 203 


Malignant pustule, . 


. 196 


Lime, burns by, 


. 225 


Mandrake powders, " 


. 341 


Lime-water wash, 




Mania-a-potu, . 


. 142 


Liniment, camphor, 


. 353 


Marasmus, in children, 


. 269 


chloroform, 


. 354 


Markshood or aconite, 


. 249 


croton oil, . 


343, 353 


Massage for stiff joints, et 


c, . 247 


hartshorn and oil, 


. 353 


Mastication of food, 


. 61 


lead ointment, . 


. 354 


May apple powders, . 


. 341 


lime, .... 




Measles, 


. 262 


mustard, 


. 353 


black, 


. 262 


opodeldoc, 


. 353 


French, 


. 262 


turpentine, 


. 354 


Meats for invalids, receipf 


s, . 327 


Liniments, 


. 353 


Medical kit, the traveler's 


. 101 


Linseed tea, receipt, 


. 323 


receipts for sick-room 


. 332 


Lint, .... 


. 3.^4 


Medicated baths, 


. 336 


Lip, hare, .... 


. 307 


Medicinal teas, . 


. 343 


salve, .... 




Medicine chests, family, 


. 101 


Lips, cracked, . 


. 192 


to take without tastin 


g, • 75 


lotion for, . 


. 3G4 


Medicines in this work, 


. 100 


Liquor, alcoholic, poisoning by 249 


Milk and cinnamon drink 


. 324 


Lithiasis, or kidney stone 


. ISO 


crust, . 


. 190 


Litter, blanket, 


. 212 


of children, 


. 304 


Liver complaints, powder 


for, . 341 


and isinglass, receipt, 


. 324 


diseases of, . 


. 178 


for puddings, etc, 


. 330 


Long sight, 


. 84 


gruel, receipt, 


. 325 


Lockjaw, . 


. 138 


punch, receipt, . 


. 323 


Looseness of the Dowels, 


. 173 


sickness, 


. 129 


in children, 


. 297, 303 


Mineral water, purgative, 


. 341 


Loss of appetite, 


. 108 


Molasses poultice, 


. 359 


of voice, 


. 160 


Moles, 


. 193 


Lotions and washes, 


. 354 


Molluscurn, 


. 191 



Index. 



43 1 





PAGE 




PAGE 


Morbili, .... 


262 


Nightingale, Florence, quoted, 


95 


Morphia, poisoning by, . 


252 


Nightshade or belladonna, 


250 


Mother's marks, 


193 


or bitter-sweet, . 


250 


Motion, the power of, 


86 


Night- sweats, . 


148 


Mouth, canker of, in children, 


28G 


Night-sweats, in consumption, 


165 


sore, in infants, . 


285 


Nitrate of potash, poisoning, . 


251 


washes and receipts, . 


362 


silver, poisoning, 


252 


Movement cure, . . 46, 247 


stains, 


193 


Movements, passive, 


246 


Night terrors of children, 


282 


series of, 


28-37 


Nose, the, 


74 


Muscles, the, 


32 


bleeding, . 


208 


development of, 


36 


catarrh of, or ozsena, 


157 


their perfection, . 


34 


polyps in, . 


158 


rapid action, 


35 


red, 


193 


voluntary, . 


34 


things in, . 


241 


Mud baths, 


338 


ulceration of, in ozsena, 


157 


Mumps, .... 


263 


Nurse, the, in sick room, 


96 


Mush poultice, . 


359 


in small-pox, 


129 


Mushrooms, poisoning by, 


251 


Nursing sore mouth, 


285 


Mustard bath, .... 


337 


Nutritive injections, 


342 


emetic, 


345 


Nux vomica, poisoning by, 


253 


liniment, . 


353 






poultice, .... 


360 


OATMEAL tea, 


325 


Mutton broth, .... 


326 


(Edema, 


149 


jelly, receipt, 


329 


Oil, castor, . . . . 


340 






cod-liver, . 


166 


NAILS, the, . 


30 


croton, . . 


343 


ingrown, .... 


195 


of tobacco, poisoning by, . 


254 


Nepk, Derbyshire, . 


197 


Ointment, Camphor, 


356 


glands of, swelling, . 


317 


carbonate of ammonia, 


356 


wry, 


233 


common, . . . . 


356 


in children, 


307 


for barber's itch, 


192 


Needles in flesh, 


241 


fetid feet, . . . . 


365 


Nerves, the, .... 


86 


goitre, . 


198 


Nervous affections, cold bath 




sunburn, . 


366 


for, 


335 


oxide of zinc, . 


356 


shallow bath for, 


338 


pile, . 


180 


system, the, 


85 


sulphur, . 


356 


natural tonics for, 


88 


tannin, . 


356 


Nervousness in children, . 


282 


Old persons, care of teeth, 


55 


Nettle rash, . . 


191 


clothing, . 


31 


Neuralgia, .... 


130 


constipation, 


172 


chloroform liniment for, . 


354 


why prone to apoplexy, . 


151 


of the heart, 


180 


Onion poultice, 


360 


remedies for, 


357 


Opium, 


102 



43- 



hide 



Opium, poisoning by, . . 252 

Opodeldoc liniment, . . . 354 

Ophthalmia, in children, . . 308 

Ovarian dropsy, . . . 149 

Oxalic acid, poisoning by, . 253 

Oxygen, in breathing, . . 59 

Oysters, stewed, receipt, . . 32S 

Oztena, or ulceration of nose, . 157 

in children, . . . 284 

PACKING, wet-sheet, . . 359 

Pads for fractured limbs, . . 214 
Pain, hot baths, poultice, etc., 

for, 358 

hygienic remedies for, . 358 

removers, .... 35G 

six receipts, . . . 357 
Painter's colic, . . i7<), 172 

Palpitation of the heart, . . ISO 

Panada, receipt, . . . 320 

Paralysis, from injury to spine, 87 

Paris green (under Arsenic), . 250 

Parotitis, 2G3 

Partridge, boiled, receipt, . 327 

Passive movements, . . . 24G 

Percussion, in consumption, . 165 

Perspiration, by what affected, . 28 

excessive, .... 143 

how reduces heat, . . 27 

Phosphorus, poisoning by, . 253 

Phthisis, or consumption, . 105 

Pigeon, boiled, receipt, . . 327 

Piles, 178 

Pimples, . . . .191 

Pins in flesh, . . . .241 

Pitting in small-pox, to prevent, 128 

Plaster, sticking, how to use, . 245 

Pleurisy, 1G3 

Pleuro-pneumonia, . . . 1G3 

Podagra, or goat, . . . 137 

Pneumonia, .... 1G3 
bilious, . . . .103 

typhoid, . . . . 1C3 

chronic, . . . . 1G1 
of children, . . .294 



PAGE 
Poison oak, sumac, or vine, . 253 
Poisons and poisoning, . 248-252 
Poor and sick, charity to, . 367 

Polyps in the nose, . . . 158 
Polypus of rectum, in children, 302 
Potash, caustic, burns by, . 225 
Potato, invalid's, mashed, . 328 
surprise, receipt, . . 328 
Potomania, .... 142 



roiomauja, 
Poultice, alum, . 




359 


arrowroot, . 




360 


bran, . 




359 


bread and milk, . 




360 


bread and water, 




358 


carrot, 




359 


charcoal, 




359 


flaxseed meal, . 




358 


molasses, . 




359 


mush, 




359 


mustard, 




360 


onion, 




360 


slippery elm, 




3G0 


starch, 




359 


turnip, 




359 


yeast, . 




350 


Poultice*, 




358 


stimulating, 




359 


Pox, chicken, . 




2G4 


small, 


. 123 


,264 


water, 




190 


wind, 




191 


Prickly heat, . 




191 


Prolapse of the anus in 


children 


,301 


Proud flesh, burnt alum for, . 


312 


Prurigo, 




191 


Prussic acid, poisoning 


by, \ 


253 


Psora, 




192 



Puddings for invalids, receipts, 330 

Pulsations of aneurisms, . 182 

the heart, . . 67, 70 

Purgative injection, . . 341 

white walnut tea, . . 349 

Purgatives, cautions, etc., . 340 

eight receipts, . . . 340 

Pustule, malignant, . . 196 



Index. 



433 





] 


3 AGE 




PAGE 


Putrid sore throat, or diphtheria, 161 


Rice gruel, receipt, . 


. 325 


or scarlet fever, 




259 


pudding, receipt, 
Rickets, .... 


. 330 

. 277 


QUININE as tonic, receipts 




300 


Ringworm, 


. 191 


powders, . 




357 


Rings, to remove, 


. 232 


Quinsy, .... 




100 


River, or milk sickness, . 


. 129 


Quoit playing, as exercise, 




45 


Rooms, proper size of, 


. 32 








Rose, or rose rash, . . 191, 193 


RACHITIS, . 




277 


rash, to tell, 


. 262 


Railroad injuries, 




232 


Roseola, 


. 191 


Rash, nettle, 




191 


to tell, . . ". . 


. 262 


rose, .... 


191 


, 193 


Rose tea, .... 


. 324 


scarlet, 




259 


"Rotkeln," . . , 


. 263 


teething, . 




190 


Rowing as exercise, 


. 45 


Ratsbane (under Arsenic), 




250 


Rubbing, in children, 


. 304 


Receipts, dietetic, . 


322-331 


Rubeola, .... 


. 202 


medical, 


33 


6-301 


Rupture, or hernia, . 


. 232 


personal hygiene, 


362-300 


in children, 


. 315 


Recovery, management during, 


99 


in infants, 


. 316 


Recreation necessary, 




46 


vomiting in, 


. 171 


Rectum, polypus of, iu child 


ren 


302 






Red lead, poisoning by, . 




251 


SAGE tea, 


. 325 


nose, .... 




193 


Sago jelly, receipt, . 


. 329 


Reducing dislocations, 




217 


Saint Anthony's fire, 


. 193 


ruptures, 




233 


Saint Vitus' dance, . 


. 155 


Relish for fish, receipt, . 




328 


cold baths for, . 


. 335 


Removal of cancers, 




317 


Sal ammoniac, for pain, . 


. 357 


Respiration, . 




58 


Salt and mustard emetic, . 


. 345 


Revaccination, importance of, 


266 


common, as an emetic, 


. 345 


Reviving vital powers in shock 


233 


hot, . ... 


. 348 






rheum, 


. 190 


mud baths for, 




338 


Saltpetre (nitrate of potash), 


. 251 


pains, remedies, 




357 


Salve for lips, . 


. 364 


scarlatina, 




116 


Salves, six receipts for, . 


. 356 


Rheumatism, 




135 


Sand baths, . . . t 


. 338 


chloroform liniment for, 




354 


hot, .... 


. 348 


diet in, 




321 


Sanitary precautions, cholera, 


. 177 


hydropathic belts for, 




342 


dwellings, . 


31,105 


of the heart, 




180 


small-pox, . 


. 129 


opodeldoc liniment for, 




353 


yellow fever, 


. 123 


Rhubarb and epsom salts, 




340 


(See also Disinfectants.) 




magnesia and, . 




340 


Sauce, bread, receipt, 


. 327 


Ribs, broken, . 




214 


Savine, oil of, poisoning, . 


. 253 


Rice and apple, receipt, . 




331 


Scabies, .... 


. 192 


blanc-mange, receipt, 




329 


Scald head, 


. 194 


37 











434 



Index. 



PAGE 


PAGE 


Scalds and burns, 


223 


Sick room, nurse, 


96 


chloral in, . 


357 


temperature, 


90 


Scalp, eczema of, 


194 


useful articles, . 


92 


■wounds, .... 


246 


waiting»pn, 


332 


Scarlatina 


253 


Sight, 


81 


anginosa, .... 


259 


defective, .... 


84 


after-effects on ear, . 


311 


old, 


8i 


maligna, .... 


259 


philosophy of . 


8? 


rheumatic, .... 


110 


short, 


84 


Scarlet fever, .... 


259 


weak, 


85 


rash, • 


259 


Sitz bath, 


338 


Scars, to remove, 


233 


Skeleton, the human, 


4S 


Sciatica, 


130 


Skin, the, 


26 


Scrofula, or scrofnlosis, . 


145 


and sense of touch, . 


70 


in children, 


271 


blisters of, . 


195 


Scrofulous affections, burdocfe 




bronzed, .... 


193 


tea for, . 


349 


cancer, .... 


310 


Scurf and baldness, receipts, 


3G3 


chapped, salve, etc., for, 356, 364 


Seborrhea, 


194 


to prevent, .... 


300 


Seidlitz powders, 


341 


diseases, .... 


190 


Sensation, philosophy of, . 


83 


forbid cold baths, 


335 


Senses, the live, 


. 73 


medicinal teas for, 


349 


Setting bones, ... 2 


7,222 


warm hath for, . 


336 


Shakes, or chills and fever, 


. Ill 


irritants for, 


333 


or Saint Vitus' dance, 


. 155 


pores and tubes of, . 


28 


Shingles, 


. 190 


spots on, .... 


193 


brow, .... 


. 190 


Skull, fracture of, . 


213 


Shock of nervous system, 2 




Sleep, 


40 


from burns and scalds, 


. 224 


to induce, .... 


142 


railroad injuries, 


. 232 


Sleeplessness, or insomnia, 


141 


Short sight, 


. 84 


Sling for broken arm, etc., 


213 


Shortening of limb from fra< 




" Slows," the, or milk sickness, 


129 




. 216 


Small-pox, . . • 12 


',, 264 


Shoulder, dislocation of, . 


. 21 i 


black, .... 


123 


growing out of, . 


. 313 


Smell, sense of, ... 


74 


Shower bath, . . . 3 




bad, to quickly remove, . 


345 


Sick, charity to poor and, 


. 3G7 


Snakes, bites of poisonous, 


206 


food and diet of, . 3 


20, 331 


Sneezing, or cold in the head, 


150 


personal attentions, . 
room, .... 




Snuffles, or cold in the head, 


150 


. 90 


of children, 


284 


air and ventilation, 


. 93 


Soothing syrup, poisoning by, 


252 


bad smell, removin 


h 345 


Sound, philosophy of, 


81 


cleanliness, 


. 96 


Sore, cold, 


198 


furniture, . 


. 91 


eyes of children, 


3'J8 


light, 


. yo 


leg, .... 


198 



Index. 



435 





PAGE 


Sore mouth, nursing, 


. 2S5 


throat, 


. 160 


clergyman's, . 


. 160 


diphtheritic, 


. 161 


of children, 


. 287 



putrid, or diphthe- 
ria, . . .161 
putrid, or scarlet fe- 
ver, . . .259 
Sores and ulcers, . . . 198 

bed, 204 

canker, , 190 

charcoal poultice for, . 359 

foul, wash for, . . . 344 

lint for dressing, . . 354 

salves for, . . . 356 

Soups, receipts for, . . . 326 

Sour stomach, .... 168 

Spasms iu asthma, . . . 162 

false croup, . . . 290 

lockjaw, .... 139 

strychnia poisoning, . . 140 

of children, . . .279 

See, also, Fits of children. 

of the bowels, . . . 170 

Spectacles, hints on using, . 84 

Spiders, bites of, 206 

Spinach soup, receijjt, . . 327 

Spinal cord, the, 85 

effects of injury, . . 87 

vital functions through, . 88 

Spinal diseases of children, 273, 313 

curvature, . . . .313 

inflammation, . . .314 

dropsy, .... 314 

Spine, the, .... 49 

Spirit wash, .... 350 

Spitting blood, .... 165 

Splinters in flesh, . . . 242 

Splints, .... 211,214 

Sponging, in lieu of bathing, . 334 

in fevers, . . . • 339 

Spots on the skin, . . . 193 

Sprains, . . . . .234 

Squinting, . ... 82 



PAGE 


Squinting in children, 


309 


Stabs, 


244 


in the chest, 


245 


Stains, iodine, to remove, 


366 


nitrate of silver, 


193 


" " to remove, 


366 


Starch poultice, 


359 


Starvation, ... 65 


144 


Steaming, ..... 


346 


Sticking plaster, how to apply, 


245 


" Stitch " in the side, or pleu- 




risy, .... 


163 


Stiffjoints or limbs, cold douche 




for, 


333 


passive movements for, 


246 


the, or milk sickness, 


129 


Stille, Prof., counter-irritants, . 


342 


Stings of bees, wasps, etc., 


235 


Stomach, the, .... 


61 


sour, 


168 


warmer for the sick, . 


92 


Stomatitis of children, 


2S5 


Stone in the bladder, 


18S 


Stools, bloody, ,, 


174 


Strabismus, in children, . 


309 


Strains, ..... 


234 


Stramonium, poisoning by, 


253 


Strangulation, treatment, 


237 


Strength not health, 


36 


Strengthening jelly, . 


329 


Stricture of the bowels, . 


172 


" Stroke " of apoplexy,- . 


151 


lightning, . 


237 


sun or heat, . 


235 


Struma, or scrofula, . 


145 


Strychnine poisoning, 


253 


Stun, treatment of, . 


222 


Stupes, ..... 


346 


Styes, 


310 


Suffocation, treatment, . . 


237 


Sugar of lead, poisoning, 


251 


Suicide, attempted, by poison, 


248 


cutting throat, . 


246 


See also Suspended Animation. 




Sulphate of iron, or copperas, 


251 



436 



Index. 





PAGE 


PAGE 


Sulphur as disinfectant, . 


. 345 


Tea, oatmeal, .... 


325 


ointment, . 


. 356 


parsley, .... 


350 


Summer complaint, . 


. 173 


pipsissewa, 


348 


of children, 


. 297 


rose, 


324 


Sunburn, .... 


. 193 


sage, 


325 


ointment for, 


. 366 


seneka, .... 


349 


to remove, . 


. 365 


seneka and liquorice, 


350 


Sunlight in sick room, 


. 96 


the invalid's, 


324 


Sunstroke, 


. 235 


walnut, white, . 


340 


Suspended animation, 


. 237 


wormseed, .... 


350 


Swamp or milk sickness, 


. 129 


Teeth, the, .... 


53 


Sweating, excessive, 


. 198 


artificial, .... 


55 


Swelled throat, or goitre, 


. 197 


causes of decay, . . 


54 


Swelling from poison vine, 


2;,:] 


knocked out, 


239 


of glands of neck, 


. 317 


periods of appearing, 


54 


Swimming as exercise, 


. 45 


their care, .... 


55 


precautions, 


. 227 


Teething fever, 


258 


Swooning, 


. 150 


Tetanus, or lockjaw, 


138 


Sycosis, 


. 191 


of the new-born, 


138 


Symptoms, etc., writing down 


, 97 


Tetter, 


191 


Syncope, .... 


. 150 


dry, 


192 






moist, 


190 


TAN, .... 


. 193 


scaly, 


192 


" Tapering off," not best mod 


e, 143 


Thermometer in sick room, 92, 102 


Tapioca jelly, receipt, 


. 329 


Thigh, broken, .... 


216 


Taste, sense of^ 


. 75 


bandaging, 


203 


Tattooing, 


29, 193 


out of joint, 


220 


Tea, bearberry, 


. 348 


Thoracic duct, .... 


62 


beef, two receipts, 


. 326 


Thorn-apple, poisoning by, 


253 


bitter-sweet, 


. 348 


Thorns in flesh, 


242 


blackberry root, 


. 349 


Throat, cut, treatment, . 


246 


burdock, . 


. 34:> 


diseases, vapor baths for, . 


337 


calamus, . . 


. 350 


Throat, sore, .... 


160 


cinchona, red, . 


. 340 


clergyman's, 


160 


cinchona, yellow, 


. 349 


diphtheritic, 


161 


dandelion, . 


. 350 


of children, . 


237 


dogwood, . 


. 349 


putrid, or diphthe- 




elder, black, 


. Sin 


ria, . 


161 


flaxseed, 


. 350 


or scarlet fever, . 


250 


goose grass, 


. 340 


swelled, or goitre, 


197 


Iceland moss, 


. 349 


things in, .... 


241 


juniper, 


. 34a 


ulcers, 


160 


linseed, 


. 323 


Thrush, 


190 


logwood, 


. 34S 


of infants, .... 


286 


oak-bark, white, 


. 349 


Thrusts, wounds from, 


244 



Index. 



437 



PAGE 

Toast and water, receipt, . . 323 

Tobacco, oil of, poisoning, . 254 

Toes, dislocation of, . . 221 

jammed, treatment, . „ 2-2 

Tongue, cut or bitten, . . 246 

tie, 307 

Tonic, cold bath as, . . . 335 

Tonics, 360 

medicinal teas for, . . 349 

natural, .... 88 

Tonsils, swelled, of children, . 287 

Tonsilitis, or sore throat, . 160 

Tooth drawing, bleeding after, 207 

Tooth powders, receipts, . . 362 

Tooth-ache, .... 363 
Toothing rash, . . . .190 

Tooth-sponge, the, ... 55 

Torsion, to check hemorrhage, 208 

Touch, sense of, ... 76 

Tourniquet, temporary, . . 209 

Tic-douloureux, . . . 130 

"Tires," the, or milk-sickness, 129 

"Trembles," or milk sickness, 129 

Trismus, or lockjaw, . . 138 

Trunk of the body, ... 49 

Truss for rupture, . . . 232 
Tubercle of the lymphatic 

glands, or scrofula, . 145 

Tuberculosis, or consumption, . 165 

Turpentine liniment, . . 354 

Typhlitis, .... 173 

Typhoid pneumonia, . . 163 

Typhus, American, . . . 118 

icterodes, . . . .118 

ULCERS, 198 

gastric, .... 168 
indolent, . . . .198 

Urine, bloody, . . . .188 

immoderate flow of, . . 189 

in Bright's disease, . . 1S5 

diabetes, .... 189 

inflammation of bladder, . 187 

inflammation of kidneys, . 184 

kidney stone, . . . 186 

37* 



PAGE 

Urine, stone in the bladder, . 188 

incontinence of, in children, 303 

Urticaria, 191 

Uvula, relaxed, . . . 160 

VACCINATION, . . 129, 
Vapor-bath, simple, . 

medicated, . 
Varicella, .... 
Varicose veins, 
Variola, .... 
Varioloid, 

Vegetables for sick, receipts, 
Veins, the, 

swollen and bursted, 
Ventilation, 

and pure air in rooms, 

of sick room, 
Ventilator, home-made, . 
Vermicelli pudding, receipt, 
Vertebra?, the, . 
Vigilance, morbid, . , 
Vinegar wash, , 
Vision, defective, 
Vital functions, how carried on 

involuntary, 
Vitriol, green, or copperas, 

as disinfectant, . 
Voice, loss of, . 
Vomiting and emetics, 

in cholera, etc., . 

in constipation, 

iu colic, 

in gastric ulcer, 

in hernia, . 

of blood, , 
Vomito, el, or yellow fever, 

WABASH scratches, 
Waiting on the sick, 
Wakefulness, or insomnia, 
Walking as exercise, . 
Warm air bath, 

bath, .... 
Warts, .... 



438 



Index. 





PAGE 




PAGE 


Warts, receipt, . ; 


. 365 


Wet-sheet packing, . 


. 339 


Wash, absorbent, 


. 356 


White lead, poisoning by, 


. 251 


borax, 


. 355 


Whitlow, 


. 197 


chlorate of potash, 


. 355 


White swelling, or scrofula, 


. 145 


cold water, 


. 355 


Whooping cough, 


. 291 


Goulard, . 


. 355 


cold baths for, . 


. 335 


lead, . 


. 355 


Wind in the bowels, . 


. 170 


lime water, 


. 355 


Windows as ventilators, . 


. 60 


oxide of zinc, . 


. 355 


Windpipe, the, . 


. 57 


spirit, 


. 355 


things in, . . . 


. 241 


vinegar, 


. 355 


Wind pox, 


. 191 


white, 


. 355 


Wine whey, receipt, . 


. 323 


Washes, . 


. 354 


Wolfsbane, or aconite, 


. 249 


face, . 


. 365 


Woolen best for clothing, 


. 31 


for the eye, 


. 346 


Worm fever, 


. 256 


mouth, 


. 362 


troubles of children, 


. 266 


three sal ammoniac, 


. 355 


Worms, marasmus often mis- 


Waste of body, how carri 


>d off, 72 


taken for, 


. 269 


Wasting fever of children 




wormseed tea for, 


. 350 


or marasmus in child 


ren, . 269 


Wounds, bleeding from, . 


. 207 


Water, barley, 


. 322 


charcoal poultice for, 


. 359 


brash, 


. 168 


dressing, . 


. 243 


cold, wash, 


• 355 


lint for, 


. 354 


gruel, receipt, . 


325 


gunshot, . 


. 243 


limestone, and lithias 


is, . 186 


lockjaw from, . . 


. 138 


on the brain, in child 


ren, . 268 


scalp, .... 


. 246 


pox, . 


. 190 


6ticking-plaster on, . 


. 245 


purgative mineral, 


. 341 


throat cut, 


. 246 


toast and, . 


. 323 


torn or lacerated, . 


. 243 


Wax in the ear, 


. 78 


See also Stabs. 




Weak ankles, in children 


, . 314 


Wry neck, 


. 233 


digestion, diet for, 


. 321 


in children, 


. 307 


eyes, . 


. 85 






Weaning brash, 


. 303 






of infants, • 


. 297 


YEAST poultice, . 


. 359 


Well-damp, . 


. 237 


" Yellow Jack," 


. 118 


Wet compress, . 


. . 339 


Yellows, in children, 


= 266 



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